Alcohol Or Drug Abuse Holtsville NY 00501

Alcohol Or Drug Abuse Holtsville NY 00501 Click To Call Now 844-291-0669

5574 Fairway Drive
Holtsville, NY 00501

Alcohol Or Drug Abuse Holtsville NY 00501
Alcohol Or Drug Abuse Holtsville NY 00501
Alcohol Or Drug Abuse Holtsville NY 00501

Addictions Recovery Measurement & the Seven Dimensions Model
Introducing a Multidimensional Recovery Measurement Model for Addictions
The sun was thought to revolve around the earth for 1500 years. It wasn’t until a European astronomer named – Nicolaus Copernicus first formulated a modern heliocentric theory of the solar system that we began to change our thinking. This insight ultimately ushered in a major paradigm shift in astronomy and physics. Every model or viewpoint for recovery maintains the integrity and importance of its own position, often to the exclusion of other explanations. For example, there are recovery models and theories for: biological, psychological, social, cultural, and spiritual viewpoints that can all explain human behavior. Unfortunately, these viewpoints may thus “blind” their adherents to alternative interpretations until some new insight is achieved that resolves the problems left unsolved. It is my hope that the 7 – Dimensions model for addictions recovery measurement is a step towards a “Copernicus” type paradigm shift.
Because human behavior is so complex, an attempt to understand the reasons individuals continue to use, and/ or abuse themselves with substances and/ or maladaptive behavioral addictions to the point of developing self-defeating behavior patterns and/ or other life-style dysfunctions or self-harm is enormously difficult to achieve. Many researchers therefore prefer to speak of risk factors that may contribute, but not be sufficient to cause addictions. They point to an eclectic bio-psychosocial approach that involves the multi-dimensional interactions of genetics, biochemistry, psychology, socio-cultural, and spiritual influences. Risk Factors / Contributory Causes / Influences:
1. Genetics (family history) – is known to play a role in causing susceptibility through such biological avenues as metabolic rates and sensitivity to alcohol and/ or other drugs or addictive behaviors.
2. Biochemistry – the discovery of morphine-like substances called endorphins (runners high, etc.) and the so-called “pleasure pathway” – the mesocorticolimbic dopamine pathway (MCLP). This is the brain center or possible anatomic site underlying addictions at which alcohol and other drugs stimulate to produce euphoria – which then becomes the desired goal to attain (tolerance – loss of control – withdrawal).
3. Psychological Factors – developmental personality traits, vulnerability to stress, and the desire for tension and symptom reduction from various mental health problems and traumatic life experiences.
Our present healthcare system is set up to focus on acute care rather than chronic illnesses. It focuses on a Unitary Syndrome model in which the sole marker of treatment response or success is specific symptom-reduction. Healthcare consumers are increasingly advocating for a multidimensional model that takes into account an array of life-functioning domains that influence patient treatment progress. Evidenced-based meta-analysis studies also purport the prognostic power of life-functioning variables to predict outcome as well as their importance for treatment planning over a unitary model that has had little empirical support. Accurate diagnosis is also dependent on a thorough multidimensional assessment process along with the possible help of a multidisciplinary treatment team approach. Behavioral Medicine practitioners have come to realize that although a disorder may be primarily physical or primarily psychological in nature, it is always a disorder of the whole person – not just of the body or the mind.
American Society of Addiction Medicine (ASAM)
The American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition”, has set the standard in the field of addiction treatment for recognizing a multidimensional, bio-psychosocial assessment process. ASAM developed the following six dimensions specifically for the addictions field with the intent to provide clinicians with decision-making guidelines for patient placement of care:
1. Acute Intoxication and/ or Withdrawal Potential
2. Biomedical Conditions and Complications
3. Emotional/ Behavioral Conditions and Complications
4. Treatment Acceptance / Resistance
5. Relapse / Continued Use Potential
6. Recovery Environment
The ASAM dimensional delineations were developed to assess severity of illness (alcoholism/ drug addiction). The severity of illness level is then used to determine the match to type and intensity of treatment to help guide placement into one of four levels of care. The dimensional assessments would involve asking if the patient’s daily living activities were significantly impaired to interfere with or distract from abstinence, recovery, and/ or stability treatment goals and efforts.
Seven Dimensions Model
In 2004, the Addictions Recovery Measurement System (ARMS), was published – describing the following seven life-functioning therapeutic activity dimensions for progress outcome measurements. As can be seen below, the ASAM (Severity of Illness) dimensions do not compete with the seven “Life-functioning” dimensions, but rather add depth in describing the Abstinence/ Relapse – 7th Dimension. Each of the seven dimensions has individualized assessment criteria:
1. Social/ Cultural – Dimension
2. Medical/ Physical – Dimension
3. Mental/ Emotional – Dimension
4. Educational/ Occupational – Dimension
5. Spiritual/ Religious – Dimension
6. Legal/ Financial – Dimension
7. Abstinence/ Relapse – Dimension
a. Acute Intoxication and/ or Withdrawal Potential
b. Biomedical Conditions and Complications
c. Emotional/ Behavioral Conditions and Complications
d. Treatment Acceptance / Resistance
e. Relapse / Continued Use Potential
f. Recovery Environment
Note: These seven dimensions have been delineated in the book entitled, Poly-behavioral Addiction and the Addictions Recovery Measurement System (Slobodzien, 2005).
The 7 – Dimension recovery model is not based upon an expanded version of the ASAM dimensions. As noted above, it was initially designed to measure patient progress by assessing therapeutic life-functioning activities. Researched may prove it to be effective as a generalized model for recovery, from all pathological diseases, disorders, and disabilities. It’s multidimensional assessment/ treatment process includes the internal interconnection of multiple dimensions from biomedical to spiritual – taking into account the effects of feedback and the existence of each dimension mutually influencing each other simultaneously. Because of the complexity of human nature, treatment progress needs to be initially tailored and guided by an individualized treatment plan based on a comprehensive bio-psychosocial assessment that identifies specific problems, goals, objectives, methods, and timetables for achieving the goals and objectives of treatment.
Life-style addictions may affect many domains of an individual’s functioning and frequently require multi-modal treatment. Goals of treatment include reduction in the use and effects of substances or achievement of abstinence, reduction in the frequency and severity of relapse, and improvement in psychological and social functioning. Real progress requires time, commitment, and discipline in thinking about it, planning for it, working the plan, and monitoring the successes made to prevent relapse. It also requires appropriate interventions and motivating strategies for each progress area of an individual’s life.
7 – Dimensions is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions. The clinical utility of the 7 – Dimensions recovery model is in its ability to assist health care providers to quickly gather detailed information about an individual’s personality, background, substance use history, affective state, self-efficacy, and coping skills for prognosis, diagnosis, treatment planning, and outcome measures.
The 7 – Dimensions hypothesis is that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The 7 Dimensions’ theory is that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension.
The 7 – Dimensions’ theory promotes a synergistically positive effect that can ignite and set free the human spirit when an individual’s life functioning dimensions are elevated in a homeostatic system. The reciprocity between spirituality and multidimensional life functioning progress, establish the deepest intrinsic self-image and behavioral changes. The underlying 7 – Dimensions theory purports that the combination of an individuals’ elevated and balanced multiple life-functioning dimensions can produce a synergistically tenacious, resilient, and spiritually positive individual homeostasis. Just as the combination of alcohol and drugs (for example valium) when taken together produce a synergistic effect (potency effects are not added together, but multiplied), and can develop into an addiction or unbalanced life-style, positive treatment effectiveness and successful outcomes are the result of a synergistic relationship with “The Higher Power.”
The 7 – Dimensions model acknowledges that family genetics, and bio-psychosocial, historical, and developmental conditioning factors are difficult and sometimes impossible to be changed within individuals. The standardized performance-based Addictions Recovery Measurement System philosophy incorporates a bio-psychosocial disease model that focuses on a cognitive behavioral perspective in attempting to alter maladaptive thinking and improve a person’s abilities and behaviors to solve problems and plan for sustained recovery. Many healthcare consumers of addiction recovery services have a genetic pre-dispositional history for addiction. They have suffered and continue to suffer from past traumatic life experiences (e.g. physical, sexual, and emotional abuse, etc.) and often present with psychosocial stressors (e.g. occupational stress, family/ marital problems, etc.) leaving them with intense and confusing feelings (e.g. anger, anxiety, bitterness, fear, guilt, grief, loneliness, depression, and inferiority, etc.) that reinforce their already low self-esteem. The complex interaction of these factors can leave the individual with much deeper mental health problems involving self-hatred, self-punishment, self-denial, low self-control, low self-respect, and a severe low self-esteem condition, with an overall (sometimes hidden) negative self-identity.
The 7 – Dimensions model combines a multidimensional force field analysis of an individual’s unique problems to identify positive strength prognostic factors, with behavioral contracting, and a token-“like”- economy point system to accomplish this task. Force field analysis is a process whereby an individual’s behavior is assessed to determine which are the key forces driving the addictive behaviors and which are the key forces restraining the addictive behaviors. A plan is implemented to identify the positive strength restraining factors to somehow manipulate those forces in order to increase the likelihood of moving an individual’s behavior in a pro-social recovery direction. Kurt Lewin (1947) who originally developed the Force Field Theory argued that an issue is held in balance by the interaction of two opposing sets of forces – those seeking to promote change (driving forces) and those attempting to maintain the status quo (restraining forces). Any given social event occurs at a given frequency in a given social context, and the frequency of the event is dependent upon forces acting to increase the event as well as forces acting to decrease the event. At any given point in time, there is a “semi-stable equilibrium” whereby the frequency of the social event will remain the same so long as there is neither change in the number or strength of the forces acting to increase the social event nor any change in the forces acting to decrease the event. Equilibrium is altered in either direction by increasing the frequency or intensity of the driving or the restraining forces and thereby creating a corresponding increase or decrease in the rate of an individual’s “addictive” behaviors.
The long-term goal is the health-consumer’s highest optimal functioning, not merely the absence of pathology or symptom reduction. The short-term goal is to change the health care system to accommodate and assimilate to a multidimensional health care perspective. The 7 – Dimensions model addresses the low self-esteem – “addiction – common denominator” by helping individuals establish values, set and accomplish goals, and monitor successful performance.
Additionally, when we consider that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the 7 – Dimensions philosophy promotes that there is a supernatural-like spiritually synergistic effect that occurs when an individuals’ multiple life functioning dimensions are elevated in a homeostatic human system. This bilateral spiritual connectedness reduces chaos and increases resilience to bring an individual harmony, wellness, and productivity. The ARMS takes an objective perspective on spirituality by assessing an individual’s positive and/ or negative spiritual/ religious dimension with the Religious Attitudes Inventory (e.g., the RAI is capable of identifying extremely unhealthy cult-like spirituality with the rigid, and intolerant religious and militant orthodoxy, practiced by some terrorists, etc.). RAI test results are also integrated into the prognostication scoring system.
The 7 – Dimensions model also promotes Twelve Step Recovery Groups such as Alcoholics and Narcotics Anonymous along with spiritual and religious recovery activities as a necessary means to maintain outcome effectiveness. The National Institute of Alcohol Abuse and Alcoholism’s most recent research findings regard such active involvement with AA/ NA as the crucial factor responsible for sustained recovery
Conclusion
The 7 – Dimensions Model is not claiming to be the panacea for the ills of addictions treatment progress and outcomes, but it is a step in the right direction for getting clinicians to change the way they practice, by changing treatment facility systems to incorporate evidence-based research findings on effective interventions. The challenge for those interested in conducting outcome evaluations to improve their quality of care is to incorporate a system that will standardize their assessment procedures, treatment programs, and clinical treatment practices. By diligently following a standardized system to obtain base-line outcome statistics of their treatment program effectiveness despite the outcome, they will be able to assess the effectiveness of subsequent treatment interventions.
For more info see:
Poly-Behavioral Addiction and the Addictions Recovery Measurement System (ARMS) at: http://www.geocities.com/drslbdzn/Behavioral_Addictions.html
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731. American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition, Retrieved, June 18, 2005, from:
http://www.asam.org/ Arthur Aron, Ph.D., professor, psychology, State University of New York, Stony Brook; Helen Fisher, research professor, department of anthropology, Rutgers University, New Brunswick, N.J.; Paul Sanberg, Ph.D.,professor, neuroscience, and director, Center of Excellence for Aging and Brain Repair,University of South Florida College of Medicine, Tampa; June 2005, the Journal of Neurophysiology Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web Publications. Retrieved June 20, 2005, from: www.tgorski.com Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40. Morgan, G.D.; and Fox, B.J. Promoting Cessation of Tobacco Use. The Physician and Sports medicine. Vol 28- No. 12, December 2000. Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5. U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000.
James Slobodzien, Psy.D., CSAC, is a Hawaii licensed psychologist and certified substance abuse counselor who earned his doctorate in Clinical Psychology. He is credentialed by the National Registry of Health Service Providers in Psychology. He has over 20-years of mental health experience primarily working in the fields of alcohol/ substance abuse and behavioral addictions in hospital, prison, and court settings. He is an adjunct professor of Psychology and also maintains a private practice as a mental health consultant.


Alcohol Or Drug Abuse Holtsville NY 00501
Alcohol Or Drug Abuse Holtsville NY 00501

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Alcohol Or Drug Abuse Holtsville NY 00544

Alcohol Or Drug Abuse Holtsville NY 00544 Click To Call Now 844-291-0669

1156 Forest Street
Holtsville, NY 00544

Alcohol Or Drug Abuse Holtsville NY 00544
Alcohol Or Drug Abuse Holtsville NY 00544
Alcohol Or Drug Abuse Holtsville NY 00544

Drug Addiction and Alcoholism; A Treatable Illness

Drug addiction and alcohol addiction are comparable to chronic illnesses like diabetes, asthma, and hypertension, and should be treated as such,according to an article published in a year 2000 issue of the Journal of the American Medical Association. Authors Thomas McLellan, Ph.D., and Herbert D. Kleber, M.D., conducted a literature review of those illnesses, revealing that there are underlying similarities between drug addiction, alcohol addiction and chronic diseases. Yet, say the researchers, drug addiction is typically treated as if it is an acute condition. Altering perceptions to think of drug addiction as a chronic illness may change the way it is treated and insured.
The researchers found that drug addiction and alcoholism shares many of the characteristics of other chronic illnesses. In the area of genetic heritability, for example, studies of monozygotic and dizygotic twins have found heritability estimates of .25 to .50 for hypertension; .80 for type 2 and .30 for type 1 diabetes; and .36 to .70 for asthma. Heritability estimates for the drug addictions are similar, ranging from .34 for heroin dependence, .55 for alcoholism, .52 for marijuana dependence, and .61 for dependence on cigarettes.
Typically, both medical professionals and the general public view drug abuse as voluntary activities. That people choose to use drugs seems to set drug addiction and alcohol adidiction apart from other chronic illnesses. Yet, there are many chronic illnesses in which voluntary choice affects initiation and maintenance of disease. Salt sensitivity, obesity, stress level, and physical inactivity, all within voluntary control, are important factors in the development of hypertension.
Drug addiction and alcoholism also resembles other chronic illnesses in regard to treatment response. The course that an drug addiction takes if left untreated is an important issue in this regard. Studies comparing treated and untreated populations of addicts have typically shown that untreated, addictions do not remit.
At this time there is no reliable “cure” for drug addiction and alcohol addiction. Typically, addicts who remain in addiction treatment and who attend follow-up have superior outcomes compared with those who do not. If you are looking for an effective drug addiction treatment program or alcohol rehab, call the national addiction treatment helpline, 1-800-511-9225 or go to www.lakeviewhealth.com.


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Alcohol Or Drug Abuse Adjuntas PR 00601

Alcohol Or Drug Abuse Adjuntas PR 00601 Click To Call Now 844-291-0669

2668 Creekside Drive
Adjuntas, PR 00601

Alcohol Or Drug Abuse Adjuntas PR 00601
Alcohol Or Drug Abuse Adjuntas PR 00601
Alcohol Or Drug Abuse Adjuntas PR 00601

Addictions Recovery Measurement & the Seven Dimensions Model
Introducing a Multidimensional Recovery Measurement Model for Addictions
The sun was thought to revolve around the earth for 1500 years. It wasn’t until a European astronomer named – Nicolaus Copernicus first formulated a modern heliocentric theory of the solar system that we began to change our thinking. This insight ultimately ushered in a major paradigm shift in astronomy and physics. Every model or viewpoint for recovery maintains the integrity and importance of its own position, often to the exclusion of other explanations. For example, there are recovery models and theories for: biological, psychological, social, cultural, and spiritual viewpoints that can all explain human behavior. Unfortunately, these viewpoints may thus “blind” their adherents to alternative interpretations until some new insight is achieved that resolves the problems left unsolved. It is my hope that the 7 – Dimensions model for addictions recovery measurement is a step towards a “Copernicus” type paradigm shift.
Because human behavior is so complex, an attempt to understand the reasons individuals continue to use, and/ or abuse themselves with substances and/ or maladaptive behavioral addictions to the point of developing self-defeating behavior patterns and/ or other life-style dysfunctions or self-harm is enormously difficult to achieve. Many researchers therefore prefer to speak of risk factors that may contribute, but not be sufficient to cause addictions. They point to an eclectic bio-psychosocial approach that involves the multi-dimensional interactions of genetics, biochemistry, psychology, socio-cultural, and spiritual influences. Risk Factors / Contributory Causes / Influences:
1. Genetics (family history) – is known to play a role in causing susceptibility through such biological avenues as metabolic rates and sensitivity to alcohol and/ or other drugs or addictive behaviors.
2. Biochemistry – the discovery of morphine-like substances called endorphins (runners high, etc.) and the so-called “pleasure pathway” – the mesocorticolimbic dopamine pathway (MCLP). This is the brain center or possible anatomic site underlying addictions at which alcohol and other drugs stimulate to produce euphoria – which then becomes the desired goal to attain (tolerance – loss of control – withdrawal).
3. Psychological Factors – developmental personality traits, vulnerability to stress, and the desire for tension and symptom reduction from various mental health problems and traumatic life experiences.
Our present healthcare system is set up to focus on acute care rather than chronic illnesses. It focuses on a Unitary Syndrome model in which the sole marker of treatment response or success is specific symptom-reduction. Healthcare consumers are increasingly advocating for a multidimensional model that takes into account an array of life-functioning domains that influence patient treatment progress. Evidenced-based meta-analysis studies also purport the prognostic power of life-functioning variables to predict outcome as well as their importance for treatment planning over a unitary model that has had little empirical support. Accurate diagnosis is also dependent on a thorough multidimensional assessment process along with the possible help of a multidisciplinary treatment team approach. Behavioral Medicine practitioners have come to realize that although a disorder may be primarily physical or primarily psychological in nature, it is always a disorder of the whole person – not just of the body or the mind.
American Society of Addiction Medicine (ASAM)
The American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition”, has set the standard in the field of addiction treatment for recognizing a multidimensional, bio-psychosocial assessment process. ASAM developed the following six dimensions specifically for the addictions field with the intent to provide clinicians with decision-making guidelines for patient placement of care:
1. Acute Intoxication and/ or Withdrawal Potential
2. Biomedical Conditions and Complications
3. Emotional/ Behavioral Conditions and Complications
4. Treatment Acceptance / Resistance
5. Relapse / Continued Use Potential
6. Recovery Environment
The ASAM dimensional delineations were developed to assess severity of illness (alcoholism/ drug addiction). The severity of illness level is then used to determine the match to type and intensity of treatment to help guide placement into one of four levels of care. The dimensional assessments would involve asking if the patient’s daily living activities were significantly impaired to interfere with or distract from abstinence, recovery, and/ or stability treatment goals and efforts.
Seven Dimensions Model
In 2004, the Addictions Recovery Measurement System (ARMS), was published – describing the following seven life-functioning therapeutic activity dimensions for progress outcome measurements. As can be seen below, the ASAM (Severity of Illness) dimensions do not compete with the seven “Life-functioning” dimensions, but rather add depth in describing the Abstinence/ Relapse – 7th Dimension. Each of the seven dimensions has individualized assessment criteria:
1. Social/ Cultural – Dimension
2. Medical/ Physical – Dimension
3. Mental/ Emotional – Dimension
4. Educational/ Occupational – Dimension
5. Spiritual/ Religious – Dimension
6. Legal/ Financial – Dimension
7. Abstinence/ Relapse – Dimension
a. Acute Intoxication and/ or Withdrawal Potential
b. Biomedical Conditions and Complications
c. Emotional/ Behavioral Conditions and Complications
d. Treatment Acceptance / Resistance
e. Relapse / Continued Use Potential
f. Recovery Environment
Note: These seven dimensions have been delineated in the book entitled, Poly-behavioral Addiction and the Addictions Recovery Measurement System (Slobodzien, 2005).
The 7 – Dimension recovery model is not based upon an expanded version of the ASAM dimensions. As noted above, it was initially designed to measure patient progress by assessing therapeutic life-functioning activities. Researched may prove it to be effective as a generalized model for recovery, from all pathological diseases, disorders, and disabilities. It’s multidimensional assessment/ treatment process includes the internal interconnection of multiple dimensions from biomedical to spiritual – taking into account the effects of feedback and the existence of each dimension mutually influencing each other simultaneously. Because of the complexity of human nature, treatment progress needs to be initially tailored and guided by an individualized treatment plan based on a comprehensive bio-psychosocial assessment that identifies specific problems, goals, objectives, methods, and timetables for achieving the goals and objectives of treatment.
Life-style addictions may affect many domains of an individual’s functioning and frequently require multi-modal treatment. Goals of treatment include reduction in the use and effects of substances or achievement of abstinence, reduction in the frequency and severity of relapse, and improvement in psychological and social functioning. Real progress requires time, commitment, and discipline in thinking about it, planning for it, working the plan, and monitoring the successes made to prevent relapse. It also requires appropriate interventions and motivating strategies for each progress area of an individual’s life.
7 – Dimensions is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions. The clinical utility of the 7 – Dimensions recovery model is in its ability to assist health care providers to quickly gather detailed information about an individual’s personality, background, substance use history, affective state, self-efficacy, and coping skills for prognosis, diagnosis, treatment planning, and outcome measures.
The 7 – Dimensions hypothesis is that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The 7 Dimensions’ theory is that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension.
The 7 – Dimensions’ theory promotes a synergistically positive effect that can ignite and set free the human spirit when an individual’s life functioning dimensions are elevated in a homeostatic system. The reciprocity between spirituality and multidimensional life functioning progress, establish the deepest intrinsic self-image and behavioral changes. The underlying 7 – Dimensions theory purports that the combination of an individuals’ elevated and balanced multiple life-functioning dimensions can produce a synergistically tenacious, resilient, and spiritually positive individual homeostasis. Just as the combination of alcohol and drugs (for example valium) when taken together produce a synergistic effect (potency effects are not added together, but multiplied), and can develop into an addiction or unbalanced life-style, positive treatment effectiveness and successful outcomes are the result of a synergistic relationship with “The Higher Power.”
The 7 – Dimensions model acknowledges that family genetics, and bio-psychosocial, historical, and developmental conditioning factors are difficult and sometimes impossible to be changed within individuals. The standardized performance-based Addictions Recovery Measurement System philosophy incorporates a bio-psychosocial disease model that focuses on a cognitive behavioral perspective in attempting to alter maladaptive thinking and improve a person’s abilities and behaviors to solve problems and plan for sustained recovery. Many healthcare consumers of addiction recovery services have a genetic pre-dispositional history for addiction. They have suffered and continue to suffer from past traumatic life experiences (e.g. physical, sexual, and emotional abuse, etc.) and often present with psychosocial stressors (e.g. occupational stress, family/ marital problems, etc.) leaving them with intense and confusing feelings (e.g. anger, anxiety, bitterness, fear, guilt, grief, loneliness, depression, and inferiority, etc.) that reinforce their already low self-esteem. The complex interaction of these factors can leave the individual with much deeper mental health problems involving self-hatred, self-punishment, self-denial, low self-control, low self-respect, and a severe low self-esteem condition, with an overall (sometimes hidden) negative self-identity.
The 7 – Dimensions model combines a multidimensional force field analysis of an individual’s unique problems to identify positive strength prognostic factors, with behavioral contracting, and a token-“like”- economy point system to accomplish this task. Force field analysis is a process whereby an individual’s behavior is assessed to determine which are the key forces driving the addictive behaviors and which are the key forces restraining the addictive behaviors. A plan is implemented to identify the positive strength restraining factors to somehow manipulate those forces in order to increase the likelihood of moving an individual’s behavior in a pro-social recovery direction. Kurt Lewin (1947) who originally developed the Force Field Theory argued that an issue is held in balance by the interaction of two opposing sets of forces – those seeking to promote change (driving forces) and those attempting to maintain the status quo (restraining forces). Any given social event occurs at a given frequency in a given social context, and the frequency of the event is dependent upon forces acting to increase the event as well as forces acting to decrease the event. At any given point in time, there is a “semi-stable equilibrium” whereby the frequency of the social event will remain the same so long as there is neither change in the number or strength of the forces acting to increase the social event nor any change in the forces acting to decrease the event. Equilibrium is altered in either direction by increasing the frequency or intensity of the driving or the restraining forces and thereby creating a corresponding increase or decrease in the rate of an individual’s “addictive” behaviors.
The long-term goal is the health-consumer’s highest optimal functioning, not merely the absence of pathology or symptom reduction. The short-term goal is to change the health care system to accommodate and assimilate to a multidimensional health care perspective. The 7 – Dimensions model addresses the low self-esteem – “addiction – common denominator” by helping individuals establish values, set and accomplish goals, and monitor successful performance.
Additionally, when we consider that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the 7 – Dimensions philosophy promotes that there is a supernatural-like spiritually synergistic effect that occurs when an individuals’ multiple life functioning dimensions are elevated in a homeostatic human system. This bilateral spiritual connectedness reduces chaos and increases resilience to bring an individual harmony, wellness, and productivity. The ARMS takes an objective perspective on spirituality by assessing an individual’s positive and/ or negative spiritual/ religious dimension with the Religious Attitudes Inventory (e.g., the RAI is capable of identifying extremely unhealthy cult-like spirituality with the rigid, and intolerant religious and militant orthodoxy, practiced by some terrorists, etc.). RAI test results are also integrated into the prognostication scoring system.
The 7 – Dimensions model also promotes Twelve Step Recovery Groups such as Alcoholics and Narcotics Anonymous along with spiritual and religious recovery activities as a necessary means to maintain outcome effectiveness. The National Institute of Alcohol Abuse and Alcoholism’s most recent research findings regard such active involvement with AA/ NA as the crucial factor responsible for sustained recovery
Conclusion
The 7 – Dimensions Model is not claiming to be the panacea for the ills of addictions treatment progress and outcomes, but it is a step in the right direction for getting clinicians to change the way they practice, by changing treatment facility systems to incorporate evidence-based research findings on effective interventions. The challenge for those interested in conducting outcome evaluations to improve their quality of care is to incorporate a system that will standardize their assessment procedures, treatment programs, and clinical treatment practices. By diligently following a standardized system to obtain base-line outcome statistics of their treatment program effectiveness despite the outcome, they will be able to assess the effectiveness of subsequent treatment interventions.
For more info see:
Poly-Behavioral Addiction and the Addictions Recovery Measurement System (ARMS) at: http://www.geocities.com/drslbdzn/Behavioral_Addictions.html
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731. American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition, Retrieved, June 18, 2005, from:
http://www.asam.org/ Arthur Aron, Ph.D., professor, psychology, State University of New York, Stony Brook; Helen Fisher, research professor, department of anthropology, Rutgers University, New Brunswick, N.J.; Paul Sanberg, Ph.D.,professor, neuroscience, and director, Center of Excellence for Aging and Brain Repair,University of South Florida College of Medicine, Tampa; June 2005, the Journal of Neurophysiology Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web Publications. Retrieved June 20, 2005, from: www.tgorski.com Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40. Morgan, G.D.; and Fox, B.J. Promoting Cessation of Tobacco Use. The Physician and Sports medicine. Vol 28- No. 12, December 2000. Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5. U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000.
James Slobodzien, Psy.D., CSAC, is a Hawaii licensed psychologist and certified substance abuse counselor who earned his doctorate in Clinical Psychology. He is credentialed by the National Registry of Health Service Providers in Psychology. He has over 20-years of mental health experience primarily working in the fields of alcohol/ substance abuse and behavioral addictions in hospital, prison, and court settings. He is an adjunct professor of Psychology and also maintains a private practice as a mental health consultant.


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Conquering drug addiction made simpler with effective drug rehab clinics

Overcoming drug addiction can be a challenging time in anyone’s life. Finding an effective drug treatment center is the best thing for anyone who is interested in kicking their bad habits and renewing their lease on life.  Trying to conquer a drug addiction is incredibly challenging, and when you try to do it without help, then your chances of success are cut dramatically. Nevertheless, if you get help at a rehab center, then you are taking a large step towards recovery. Since the process is so prolonged and involved, you need to do things right the first time, which means deciding on the best center for your requirements.
If you try to overcome a drug addiction alone, the chances of relapses will be greater. Sometimes you can also go to a rehabilitation center but still relapse, which is why it is even more crucial to choose the right center. You do not want to endure the process more than once, due to the emotional and physical demands. Hence select the right program for the greatest chance at success.
When you are thinking about a drug addiction program, search for one which is tailored to your desires and not one that is a one-size-fits-all sort of program. You will have a much better chance to overcome your addiction if you get personal attention. Many people do not think to look for programs that help with the side effects of drug abuse, like depression and eating disorders, therefore find something that can control every aspect you might be dealing with rather than the initial symptom.
Look for a plan that helps you every step of the way, from the initiation until after you are reinstated to your normal lifestyle. You need a drug addiction program that will help your family have an understanding of what your situation is so that they can know how they might be able to help or watch for warning signs.
A drug addiction program should help you feel at ease in your environment. The program is going to be difficult, so you want something that will allow you to loosen up as much as you can. Locate a treatment center that has yoga, spas, massages and much more. You are not being penalized for your addiction, therefore you don’t need every single part of the program to be uncomfortable.
You have a much better chance at success with overcoming your drug addiction when you are relaxed because you will feel more at home. You’ll have a more positive experience, and as such, be less likely to backslide once you go back home.
Privacy and an experienced staff are two things that you ought to take into account when considering a drug addiction center. Try to look for a rehabilitation center that is staffed with experts who value your privacy as much as you do, and treat you as an individual, not as a convict.
When you’re choosing a center to help you with your drug addiction, evaluate their after-care plan to prevent relapsing. If you wish to keep on your path to freedom, then you need something that will help you remain drug free outside of that safe environment. Get a customized plan and know that you can make the change to have a better life.


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Drug Abuse And Drug Addiction Facts

Drug abuse and drug addiction is a very serious problem. What starts out as a simple curiosity or use that is considered social may result in a serious addiction. Drug abuse is a very serious problem in many places in the world, particularly the United States. What starts out as a simple curiosity or use that is considered social may result in a serious addiction.Many individuals start using a particular drug and find that they have total control over their habit. However, after a certain period of time, these people may start to lose the control that they once had. Eventually, it will take more and more of the same type of drug for the individual to achieve the same state of euphoria as they experienced previously.An individual who abuses drugs can develop an addiction that is psychological, physical, or emotional. By the time that the drug abuse reaches its peak, or an individual seeks assistance for their drug addiction, the addiction can be a combination of physical, emotional, and psychological conditions. This is due to the fact that the more that an individual is subjected to the drug that they are abusing, the chemistry of the body starts to change. These changes often result in the negative consequences of being unable to control the urges and impulses that are commonly associated with drug abuse.It is common for a drug addiction to result in many biological changes to occur within the body of an abuser. This is why many people who abuse drugs seem to change so drastically. Many individuals experience weight loss or weight gain, a change in personality, changes in moods, memory impairment, loss in general gross motor skills, and many may even develop various types of chronic medical conditions. Whereas the normal person is often motivated by many factors in their life, those that engage in drug abuse have one motivating factor. That is, ultimately, to abuse the drug that they have been experimenting with.Many people who abuse drugs seek treatment for their disease. However, not every person comes out of treatment successfully. Many people must receive treatment more than once to prove effective. It has been discovered that there are very few individuals that seek treatment for their condition based on self-motivation alone. Many individuals who enroll for therapy to alleviate the compulsive drug addiction that they have are forced to do so. The State may order the therapy, or a family member may prompt one to seek help. However, most of the time, many of these individuals successfully complete the treatment.There are many drug abuse treatment programs available. Seeing that every person is different than another person, and some may be more receptive than others, not all treatment methods will prove to be effective for every single person with an addiction to drugs. It is important to not relinquish hope. If one form of treatment does not work for you, there is another form of treatment available that will work for you.If you are looking into drug abuse treatment for yourself, or someone that you care about, you will discover that there are many different types of programs to select from. Many of these are short term, but there are quite a few that are for periods of time that are equal to three months or more. The reason that there are such a large number of long term programs is because these have proven to release the most successful recoveries of drug abuse.It is vital that you understand that a treatment program sets the recovery in motion. There are many other factors that can have a great impact on the individual who is attempting to beat an addiction to drugs. This includes emotional support from friends and members of the family, supervision, the implementation of an accountability partner that they can contact any time day or night, and continued therapy.Drug abuse is a common problem, but it is not a problem that cannot be solved. There are many ways that an individual who suffers from this devastating can get the assistance that they require in order to successfully resolve their problem. It is important for these individuals to understand that the loss of control that they have experienced as a result of the addiction is not a weakness, but a result of the biological changes that occur within the body. Providing resources for assistance and support for the drug abuser is the best contribution that can be given in order to achieve a successful recovery.


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Basic Information On Treatment For Drug Addiction

With the fact that Drug Addiction is catching up fast and is as deadly as the Human Immuno Virus spread Acquired Immuno Deficiency Syndrome (AIDS), it is extremely important that we look at ways of tr… With the fact that Drug Addiction is catching up fast and is as deadly as the Human Immuno Virus spread Acquired Immuno Deficiency Syndrome (AIDS), it is extremely important that we look at ways of treating drug addiction. We all know it is a major issue with a cross section of people affected by drug addiction. Treatment of drug addiction is a combination of traditional, spiritual and the medical way which allows the patient to combat drug addiction. Treatments for drug addictions are always administered in facilities like clinics, hospitals, drug rehab centers etc. in the presence of trained physicians in administering addiction medicine and doctors who are specialized in treating addiction related cases. It may seem that treatment of drugs is very simple, but in fact treatment centers have to be ultra cautious with their patients who enroll in drug rehab or treatment programs. The first step of any treatment for drug addiction is detoxification. The effect of consuming drugs like Marijuana, Cocaine is that the toxic remnants of these drugs are left behind in the human body. The detoxification process detoxifies or removes all these toxic remnants from the body. Detoxification in itself is a simple process but it can get complicated in cases where the drug addict has a history of consuming drugs for a long time. Post the detoxification, the actual treatment for drug rehabilitation is prescribed by the doctor or the physician. Normally, these tests last about two weeks and may require the patient to either choose an in-house residential program or an outpatient program. Cases where the person is found to be a heavy opiate or has been consuming drugs like heroin, cocaine for a long time, an FDA approved drug called methadone is used for the treatment. The process of treatment of such cases may take longer and it may take up to 6 months to a year for the person to complete the treatment. That said, the patients who undergo such treatments will see the benefits of the treatment coming to them a year after the treatment is over. A good treatment of drug addiction cases involves individual and group counseling and group therapy in addition to the medical treatment. Many companies/centers/clinics offer treatment for drug addiction. With most of them affordably priced, drug addiction treatment is almost becoming a necessity for all those who have a history of drug addiction.Remember, treatment for drug addiction is not mandatory for a person. But in order to save a lot of your efforts trying to grapple with the serious negative effects which accompany drug addiction, you are well advised to take a treatment for drug addiction.


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Drug Addiction and Alcoholism; A Treatable Illness

Drug addiction and alcohol addiction are comparable to chronic illnesses like diabetes, asthma, and hypertension, and should be treated as such,according to an article published in a year 2000 issue of the Journal of the American Medical Association. Authors Thomas McLellan, Ph.D., and Herbert D. Kleber, M.D., conducted a literature review of those illnesses, revealing that there are underlying similarities between drug addiction, alcohol addiction and chronic diseases. Yet, say the researchers, drug addiction is typically treated as if it is an acute condition. Altering perceptions to think of drug addiction as a chronic illness may change the way it is treated and insured.
The researchers found that drug addiction and alcoholism shares many of the characteristics of other chronic illnesses. In the area of genetic heritability, for example, studies of monozygotic and dizygotic twins have found heritability estimates of .25 to .50 for hypertension; .80 for type 2 and .30 for type 1 diabetes; and .36 to .70 for asthma. Heritability estimates for the drug addictions are similar, ranging from .34 for heroin dependence, .55 for alcoholism, .52 for marijuana dependence, and .61 for dependence on cigarettes.
Typically, both medical professionals and the general public view drug abuse as voluntary activities. That people choose to use drugs seems to set drug addiction and alcohol adidiction apart from other chronic illnesses. Yet, there are many chronic illnesses in which voluntary choice affects initiation and maintenance of disease. Salt sensitivity, obesity, stress level, and physical inactivity, all within voluntary control, are important factors in the development of hypertension.
Drug addiction and alcoholism also resembles other chronic illnesses in regard to treatment response. The course that an drug addiction takes if left untreated is an important issue in this regard. Studies comparing treated and untreated populations of addicts have typically shown that untreated, addictions do not remit.
At this time there is no reliable “cure” for drug addiction and alcohol addiction. Typically, addicts who remain in addiction treatment and who attend follow-up have superior outcomes compared with those who do not. If you are looking for an effective drug addiction treatment program or alcohol rehab, call the national addiction treatment helpline, 1-800-511-9225 or go to www.lakeviewhealth.com.


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Drug Abuse And Drug Addiction Facts

Drug abuse and drug addiction is a very serious problem. What starts out as a simple curiosity or use that is considered social may result in a serious addiction. Drug abuse is a very serious problem in many places in the world, particularly the United States. What starts out as a simple curiosity or use that is considered social may result in a serious addiction.Many individuals start using a particular drug and find that they have total control over their habit. However, after a certain period of time, these people may start to lose the control that they once had. Eventually, it will take more and more of the same type of drug for the individual to achieve the same state of euphoria as they experienced previously.An individual who abuses drugs can develop an addiction that is psychological, physical, or emotional. By the time that the drug abuse reaches its peak, or an individual seeks assistance for their drug addiction, the addiction can be a combination of physical, emotional, and psychological conditions. This is due to the fact that the more that an individual is subjected to the drug that they are abusing, the chemistry of the body starts to change. These changes often result in the negative consequences of being unable to control the urges and impulses that are commonly associated with drug abuse.It is common for a drug addiction to result in many biological changes to occur within the body of an abuser. This is why many people who abuse drugs seem to change so drastically. Many individuals experience weight loss or weight gain, a change in personality, changes in moods, memory impairment, loss in general gross motor skills, and many may even develop various types of chronic medical conditions. Whereas the normal person is often motivated by many factors in their life, those that engage in drug abuse have one motivating factor. That is, ultimately, to abuse the drug that they have been experimenting with.Many people who abuse drugs seek treatment for their disease. However, not every person comes out of treatment successfully. Many people must receive treatment more than once to prove effective. It has been discovered that there are very few individuals that seek treatment for their condition based on self-motivation alone. Many individuals who enroll for therapy to alleviate the compulsive drug addiction that they have are forced to do so. The State may order the therapy, or a family member may prompt one to seek help. However, most of the time, many of these individuals successfully complete the treatment.There are many drug abuse treatment programs available. Seeing that every person is different than another person, and some may be more receptive than others, not all treatment methods will prove to be effective for every single person with an addiction to drugs. It is important to not relinquish hope. If one form of treatment does not work for you, there is another form of treatment available that will work for you.If you are looking into drug abuse treatment for yourself, or someone that you care about, you will discover that there are many different types of programs to select from. Many of these are short term, but there are quite a few that are for periods of time that are equal to three months or more. The reason that there are such a large number of long term programs is because these have proven to release the most successful recoveries of drug abuse.It is vital that you understand that a treatment program sets the recovery in motion. There are many other factors that can have a great impact on the individual who is attempting to beat an addiction to drugs. This includes emotional support from friends and members of the family, supervision, the implementation of an accountability partner that they can contact any time day or night, and continued therapy.Drug abuse is a common problem, but it is not a problem that cannot be solved. There are many ways that an individual who suffers from this devastating can get the assistance that they require in order to successfully resolve their problem. It is important for these individuals to understand that the loss of control that they have experienced as a result of the addiction is not a weakness, but a result of the biological changes that occur within the body. Providing resources for assistance and support for the drug abuser is the best contribution that can be given in order to achieve a successful recovery.


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The Physical and Emotional Effects of Alcoholism

Download – Royalty Free Stock Photographyfrom © Dreamstime.com
Alcoholism has emerged as one of the major social problems these days. Not only family but state Governments too are expressing their deep concerns over the growing rate of Alcoholism. Reports say if the rate of alcoholism continued in the same manner it would adversely affect the overall productivity of a country. Alcoholism is a serious and terrible social problem because it has the potential to adversely affect the physical as well as the mental status of a person.
One of the major problems with alcoholism and drug addiction is that people slowly become dependent upon these substances and it becomes pretty tough to get rid of those. Even if they are willing to leave this habit they won’t be able to do so and they will experience some withdrawal symptoms. The duration and effect of withdrawal symptoms can range from a few days to weeks. The degree of its severity also ranges from mild to serious and in some cases it may lead to death.
Alcoholism and drug addiction is a substance abuse problem that is repeated and excessive. This substance is used to create effects or imagined effects. As a person becomes more and more addicted and sinks deeper into these substances they could experience abnormal physical and mental behaviors like mood swings, abnormal social and communication behavior, personality changes and many others. When we talk about physical changes it may include liver damage and failure, redness and rashes in eyes, dry skin, dry lips, forgetfulness and many others.
Viewing its long term impact on the overall personality of a person it is essential to know what physical and emotional effects alcoholism could bring in and what should be done in case you are in the same trap. With this article we have come-up with certain facts that could decipher what physical and mental effects does alcoholism brings in.
Gastrointestinal problems: The first system that gets adversely affected by alcoholism is the gastrointestinal system or commonly called as digestive system. A higher concentration of alcohol in body leads to weakened liver and ultimately to a weak digestive system.
Cardio vascular complications: Experts are of the opinion that a higher concentration of alcohol in human body also has negative impact on our respiratory and cardio vascular system as it may leads to many cardio vascular complication including hypertension and cardiomyopathy.
Weakened immunity system: Immune system is one of the most important systems in human body, it is our defense mechanism, and it recognizes foreign antigens and chemicals in the body and elicits some defense mechanism to get rid of the antigen. However regular alcohol intake could affect our immune system negatively and ultimately leads to a weakened immune system.
Infections and infectious diseases: Continuous intake of alcohol could leads to serious infections including pneumonia and tuberculosis which could adversely affect our respiratory system as a whole.
Nervous system disorders: Experts have opined that excessive level of alcohol in body could also damage our peripheral and central nervous system that could result into many nervous system disorders and much cognitive impairment.
Impotency: Alcoholism not only affects our digestive and respiratory system but it also affects the main system of human body that is the reproductive system. Alcoholic males have been reported of testicular atrophy, impotency and gynecomastia.
Fetal alcohol syndrome: Those women who drink need to be more conscious as alcohol may not only affect their body but it will also have negative impact on their fetus. Experts are of the opinion that taking alcohol during pregnancy can leads to mental retardation, facial deformity and neurological problems.
Viewing the major impact of alcoholism to a person’s overall personality it is important to take adequate measures so that they don’t get into this trap. And if it is unavoidable and somehow they have already sunk into this trap adequate steps ought to be taken to get rid of this social menace.
Alcoholism is a chronic addiction. It is a persistent disease, which needs medical help, when gets out of control. People, who suffer from this addiction, cannot do without alcohol. If some one consumes moderate quantities of alcohol, it is not harmful but when it turns into binge drinking and excessive drinking, it becomes a disease called Alcoholism. It is an addiction and people suffering from it have no control over their drinking. They drink a lot and frequently. They get dependent on alcohol.
Alcoholic prefers to drink alone in secret. Other signs and symptoms of this addiction are not being able to limit how much alcohol is consumed, short term memory loss, loosing interest in social life, hobbies and activities and having a great urge to drink all the time. They develop their drinking rituals and do not like any interference in this. They get irritable, when they want a drink and intensity of their feeling increases, if they do not get alcohol.
Alcoholism makes people nauseate or sweat, when they do not get drink. They start hiding alcohol in unlikely places and try to gulp down the drink as fast as they could, when they get it. They develop relationship problems, problems at work place and other social problems as they start avoiding social activities. They always have an urge for a larger quantity of alcohol to feel its effect. Alcoholism affects an addict physically, psychologically and socially. Drinking becomes a compulsion for him or her.
For more information visit:http://www.unsafedrugs.com/physical-emotional-effects-alcoholism/Video Source: Youtube
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Addictions Recovery Measurement & the Seven Dimensions Model
Introducing a Multidimensional Recovery Measurement Model for Addictions
The sun was thought to revolve around the earth for 1500 years. It wasn’t until a European astronomer named – Nicolaus Copernicus first formulated a modern heliocentric theory of the solar system that we began to change our thinking. This insight ultimately ushered in a major paradigm shift in astronomy and physics. Every model or viewpoint for recovery maintains the integrity and importance of its own position, often to the exclusion of other explanations. For example, there are recovery models and theories for: biological, psychological, social, cultural, and spiritual viewpoints that can all explain human behavior. Unfortunately, these viewpoints may thus “blind” their adherents to alternative interpretations until some new insight is achieved that resolves the problems left unsolved. It is my hope that the 7 – Dimensions model for addictions recovery measurement is a step towards a “Copernicus” type paradigm shift.
Because human behavior is so complex, an attempt to understand the reasons individuals continue to use, and/ or abuse themselves with substances and/ or maladaptive behavioral addictions to the point of developing self-defeating behavior patterns and/ or other life-style dysfunctions or self-harm is enormously difficult to achieve. Many researchers therefore prefer to speak of risk factors that may contribute, but not be sufficient to cause addictions. They point to an eclectic bio-psychosocial approach that involves the multi-dimensional interactions of genetics, biochemistry, psychology, socio-cultural, and spiritual influences. Risk Factors / Contributory Causes / Influences:
1. Genetics (family history) – is known to play a role in causing susceptibility through such biological avenues as metabolic rates and sensitivity to alcohol and/ or other drugs or addictive behaviors.
2. Biochemistry – the discovery of morphine-like substances called endorphins (runners high, etc.) and the so-called “pleasure pathway” – the mesocorticolimbic dopamine pathway (MCLP). This is the brain center or possible anatomic site underlying addictions at which alcohol and other drugs stimulate to produce euphoria – which then becomes the desired goal to attain (tolerance – loss of control – withdrawal).
3. Psychological Factors – developmental personality traits, vulnerability to stress, and the desire for tension and symptom reduction from various mental health problems and traumatic life experiences.
Our present healthcare system is set up to focus on acute care rather than chronic illnesses. It focuses on a Unitary Syndrome model in which the sole marker of treatment response or success is specific symptom-reduction. Healthcare consumers are increasingly advocating for a multidimensional model that takes into account an array of life-functioning domains that influence patient treatment progress. Evidenced-based meta-analysis studies also purport the prognostic power of life-functioning variables to predict outcome as well as their importance for treatment planning over a unitary model that has had little empirical support. Accurate diagnosis is also dependent on a thorough multidimensional assessment process along with the possible help of a multidisciplinary treatment team approach. Behavioral Medicine practitioners have come to realize that although a disorder may be primarily physical or primarily psychological in nature, it is always a disorder of the whole person – not just of the body or the mind.
American Society of Addiction Medicine (ASAM)
The American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition”, has set the standard in the field of addiction treatment for recognizing a multidimensional, bio-psychosocial assessment process. ASAM developed the following six dimensions specifically for the addictions field with the intent to provide clinicians with decision-making guidelines for patient placement of care:
1. Acute Intoxication and/ or Withdrawal Potential
2. Biomedical Conditions and Complications
3. Emotional/ Behavioral Conditions and Complications
4. Treatment Acceptance / Resistance
5. Relapse / Continued Use Potential
6. Recovery Environment
The ASAM dimensional delineations were developed to assess severity of illness (alcoholism/ drug addiction). The severity of illness level is then used to determine the match to type and intensity of treatment to help guide placement into one of four levels of care. The dimensional assessments would involve asking if the patient’s daily living activities were significantly impaired to interfere with or distract from abstinence, recovery, and/ or stability treatment goals and efforts.
Seven Dimensions Model
In 2004, the Addictions Recovery Measurement System (ARMS), was published – describing the following seven life-functioning therapeutic activity dimensions for progress outcome measurements. As can be seen below, the ASAM (Severity of Illness) dimensions do not compete with the seven “Life-functioning” dimensions, but rather add depth in describing the Abstinence/ Relapse – 7th Dimension. Each of the seven dimensions has individualized assessment criteria:
1. Social/ Cultural – Dimension
2. Medical/ Physical – Dimension
3. Mental/ Emotional – Dimension
4. Educational/ Occupational – Dimension
5. Spiritual/ Religious – Dimension
6. Legal/ Financial – Dimension
7. Abstinence/ Relapse – Dimension
a. Acute Intoxication and/ or Withdrawal Potential
b. Biomedical Conditions and Complications
c. Emotional/ Behavioral Conditions and Complications
d. Treatment Acceptance / Resistance
e. Relapse / Continued Use Potential
f. Recovery Environment
Note: These seven dimensions have been delineated in the book entitled, Poly-behavioral Addiction and the Addictions Recovery Measurement System (Slobodzien, 2005).
The 7 – Dimension recovery model is not based upon an expanded version of the ASAM dimensions. As noted above, it was initially designed to measure patient progress by assessing therapeutic life-functioning activities. Researched may prove it to be effective as a generalized model for recovery, from all pathological diseases, disorders, and disabilities. It’s multidimensional assessment/ treatment process includes the internal interconnection of multiple dimensions from biomedical to spiritual – taking into account the effects of feedback and the existence of each dimension mutually influencing each other simultaneously. Because of the complexity of human nature, treatment progress needs to be initially tailored and guided by an individualized treatment plan based on a comprehensive bio-psychosocial assessment that identifies specific problems, goals, objectives, methods, and timetables for achieving the goals and objectives of treatment.
Life-style addictions may affect many domains of an individual’s functioning and frequently require multi-modal treatment. Goals of treatment include reduction in the use and effects of substances or achievement of abstinence, reduction in the frequency and severity of relapse, and improvement in psychological and social functioning. Real progress requires time, commitment, and discipline in thinking about it, planning for it, working the plan, and monitoring the successes made to prevent relapse. It also requires appropriate interventions and motivating strategies for each progress area of an individual’s life.
7 – Dimensions is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions. The clinical utility of the 7 – Dimensions recovery model is in its ability to assist health care providers to quickly gather detailed information about an individual’s personality, background, substance use history, affective state, self-efficacy, and coping skills for prognosis, diagnosis, treatment planning, and outcome measures.
The 7 – Dimensions hypothesis is that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The 7 Dimensions’ theory is that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension.
The 7 – Dimensions’ theory promotes a synergistically positive effect that can ignite and set free the human spirit when an individual’s life functioning dimensions are elevated in a homeostatic system. The reciprocity between spirituality and multidimensional life functioning progress, establish the deepest intrinsic self-image and behavioral changes. The underlying 7 – Dimensions theory purports that the combination of an individuals’ elevated and balanced multiple life-functioning dimensions can produce a synergistically tenacious, resilient, and spiritually positive individual homeostasis. Just as the combination of alcohol and drugs (for example valium) when taken together produce a synergistic effect (potency effects are not added together, but multiplied), and can develop into an addiction or unbalanced life-style, positive treatment effectiveness and successful outcomes are the result of a synergistic relationship with “The Higher Power.”
The 7 – Dimensions model acknowledges that family genetics, and bio-psychosocial, historical, and developmental conditioning factors are difficult and sometimes impossible to be changed within individuals. The standardized performance-based Addictions Recovery Measurement System philosophy incorporates a bio-psychosocial disease model that focuses on a cognitive behavioral perspective in attempting to alter maladaptive thinking and improve a person’s abilities and behaviors to solve problems and plan for sustained recovery. Many healthcare consumers of addiction recovery services have a genetic pre-dispositional history for addiction. They have suffered and continue to suffer from past traumatic life experiences (e.g. physical, sexual, and emotional abuse, etc.) and often present with psychosocial stressors (e.g. occupational stress, family/ marital problems, etc.) leaving them with intense and confusing feelings (e.g. anger, anxiety, bitterness, fear, guilt, grief, loneliness, depression, and inferiority, etc.) that reinforce their already low self-esteem. The complex interaction of these factors can leave the individual with much deeper mental health problems involving self-hatred, self-punishment, self-denial, low self-control, low self-respect, and a severe low self-esteem condition, with an overall (sometimes hidden) negative self-identity.
The 7 – Dimensions model combines a multidimensional force field analysis of an individual’s unique problems to identify positive strength prognostic factors, with behavioral contracting, and a token-“like”- economy point system to accomplish this task. Force field analysis is a process whereby an individual’s behavior is assessed to determine which are the key forces driving the addictive behaviors and which are the key forces restraining the addictive behaviors. A plan is implemented to identify the positive strength restraining factors to somehow manipulate those forces in order to increase the likelihood of moving an individual’s behavior in a pro-social recovery direction. Kurt Lewin (1947) who originally developed the Force Field Theory argued that an issue is held in balance by the interaction of two opposing sets of forces – those seeking to promote change (driving forces) and those attempting to maintain the status quo (restraining forces). Any given social event occurs at a given frequency in a given social context, and the frequency of the event is dependent upon forces acting to increase the event as well as forces acting to decrease the event. At any given point in time, there is a “semi-stable equilibrium” whereby the frequency of the social event will remain the same so long as there is neither change in the number or strength of the forces acting to increase the social event nor any change in the forces acting to decrease the event. Equilibrium is altered in either direction by increasing the frequency or intensity of the driving or the restraining forces and thereby creating a corresponding increase or decrease in the rate of an individual’s “addictive” behaviors.
The long-term goal is the health-consumer’s highest optimal functioning, not merely the absence of pathology or symptom reduction. The short-term goal is to change the health care system to accommodate and assimilate to a multidimensional health care perspective. The 7 – Dimensions model addresses the low self-esteem – “addiction – common denominator” by helping individuals establish values, set and accomplish goals, and monitor successful performance.
Additionally, when we consider that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the 7 – Dimensions philosophy promotes that there is a supernatural-like spiritually synergistic effect that occurs when an individuals’ multiple life functioning dimensions are elevated in a homeostatic human system. This bilateral spiritual connectedness reduces chaos and increases resilience to bring an individual harmony, wellness, and productivity. The ARMS takes an objective perspective on spirituality by assessing an individual’s positive and/ or negative spiritual/ religious dimension with the Religious Attitudes Inventory (e.g., the RAI is capable of identifying extremely unhealthy cult-like spirituality with the rigid, and intolerant religious and militant orthodoxy, practiced by some terrorists, etc.). RAI test results are also integrated into the prognostication scoring system.
The 7 – Dimensions model also promotes Twelve Step Recovery Groups such as Alcoholics and Narcotics Anonymous along with spiritual and religious recovery activities as a necessary means to maintain outcome effectiveness. The National Institute of Alcohol Abuse and Alcoholism’s most recent research findings regard such active involvement with AA/ NA as the crucial factor responsible for sustained recovery
Conclusion
The 7 – Dimensions Model is not claiming to be the panacea for the ills of addictions treatment progress and outcomes, but it is a step in the right direction for getting clinicians to change the way they practice, by changing treatment facility systems to incorporate evidence-based research findings on effective interventions. The challenge for those interested in conducting outcome evaluations to improve their quality of care is to incorporate a system that will standardize their assessment procedures, treatment programs, and clinical treatment practices. By diligently following a standardized system to obtain base-line outcome statistics of their treatment program effectiveness despite the outcome, they will be able to assess the effectiveness of subsequent treatment interventions.
For more info see:
Poly-Behavioral Addiction and the Addictions Recovery Measurement System (ARMS) at: http://www.geocities.com/drslbdzn/Behavioral_Addictions.html
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731. American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition, Retrieved, June 18, 2005, from:
http://www.asam.org/ Arthur Aron, Ph.D., professor, psychology, State University of New York, Stony Brook; Helen Fisher, research professor, department of anthropology, Rutgers University, New Brunswick, N.J.; Paul Sanberg, Ph.D.,professor, neuroscience, and director, Center of Excellence for Aging and Brain Repair,University of South Florida College of Medicine, Tampa; June 2005, the Journal of Neurophysiology Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web Publications. Retrieved June 20, 2005, from: www.tgorski.com Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40. Morgan, G.D.; and Fox, B.J. Promoting Cessation of Tobacco Use. The Physician and Sports medicine. Vol 28- No. 12, December 2000. Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5. U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000.
James Slobodzien, Psy.D., CSAC, is a Hawaii licensed psychologist and certified substance abuse counselor who earned his doctorate in Clinical Psychology. He is credentialed by the National Registry of Health Service Providers in Psychology. He has over 20-years of mental health experience primarily working in the fields of alcohol/ substance abuse and behavioral addictions in hospital, prison, and court settings. He is an adjunct professor of Psychology and also maintains a private practice as a mental health consultant.


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