Video Transcript: Lesson 3
Addiction. Addiction has many faces, as I'm sure you know, in your life, there are many faces to your personality. There are many faces to your work. There are many faces to life. Overall, an addiction is just like it. It has many different faces. In this video, we're going to talk about the addiction models. What models of addiction can we look at to understand better how it works? It brings me to the question of this and many have asked this question for years as we well, we those who are in mental health, have been trying to understand, how do I help the addict? How do I understand my arms around addiction as a discipline, also as an issue that has to be dealt with, that has to be addressed. Is it a disease, or is it a choice, a behavior, or is it both? It's very interesting, because it goes from one extreme to another extreme. I liken it to this. Think about, let's say you're a parent. I'm a parent of two boys, one who is now 22 and another who is 15. But when my 22 year old was younger, and he is four years old, and he was observing everything you know four year olds are. And as I was going about the house and watching my four year old at the time do this and do that, and also when he would get up in the morning or at later at night, how he behave, I would say now, Andrew, Andrew, it's your choice. It's your because if he were to get into bit of a tantrum or get frustrated and and he wants something that he wants right now and say, he wants this bottle of water, and we are We don't want him to have that bottle of water at that time because it's just before bedtime, or to watch that next television show because it's almost time to go down to sleep for the night. And he is making a fuss, let's say, and, and he's a crying and and hitting the furniture and and stomping and and four year olds, and you step back as a parent, and if this happens all the time, and maybe you're a parent watching today, if they need, yeah, how do I handle this? Is it? How do I help him to to just or her to stop that. It's kind of like the the two year old who who is doesn't want the sweater put on her or him, and you're the mom or you're the dad, you're ready to put a sweater on because the cold day, you know it's going to be the right thing for them, and they don't want that. They finally give up and put the hands up and say, Okay, put that sweater on. Doesn't they tell you that? But they say, okay, and you put the sweater on and it fits. Coming back to my son, Andrew, when he was four, and we said, okay, Andrew, you can choose to go to bed now and there's no issue, no problem. Or you can keep on crying, keep on carrying on. And you can also keep kicking the couch, hitting the chair, yelling and screaming, and you'll lose more screen time where you won't be able to watch more television shows tomorrow. TV is taken away, and if you choose to keep going on, even more option number three, TV time is taken away. We'll take away your Pokemon cards. We'll take away all these other things from you. Which do you want? It's your choice. Andrew, it's your choice. And now at this time, Andrew is a single he's an only child, rather, and yes, he's single too. Of course, he's only child. And so it was just my wife and me, and we were able to kind of reinforce it, and have other siblings in the way, and so. And of course,
Andrew being a first. Born, and that only child, he didn't have much to be distracted by, and so he he thought for about it a minute, because this really did happen. As far as you know, I'm giving you an example of the type of things that we had to deal with him. But this actually happened about that, that age where he was trying to decide how to behave this way or that way, and we would tell Andrew often about many situations. It's your choice. Now, often, to Andrew's credit, he would choose option number one. He would go to bed. He would stop watching the television show. He would comply well, because he wanted to honor his father, honor his mother, to be obedient. He he knew that if it boy, because he thought about it, if I do go to bed now, and of course, it took a little bit of a process, but if I do go to bed now, I will be able to watch TV the next day. I'll be able to do this the next next day, I'll be able to carry on with life as I know it. But there were once in the times, once in a while, where he would still carry on, or he would still do the naughty behavior and be disobedient a bit. And we would say, all right, Andrew, or take this away, or take that away for a few days. You just chose it. You just chose it. Then at that, during that very time of Andrew's life, there was a day that I was having a bit of a problem, I was frustrated and and he would watch me go back and forth and and hit something because I was, I was frustrated and angry And and and trying to moving things around. And thinking and maybe mutter something I shouldn't, and I tried to not mutter to things that were offensive, of course, and that you, and generally you try not to. And after a good 10 minutes of this, my son, Andrew, at the age of four, stops me in my tracks, Daddy, Daddy, and I turn and yeah, what is it, Andrew? Daddy, it's your choice. Daddy, it's your choice. Out in the mouth of babes, what I was doing with my son, my son did to me. Hence the whole picture of what addiction does to us, between us and God. God as our Father, as our Creator, and we as God's children. And God is saying to you and me, it's your choice. John, Sue, Mark, Tim, Mary, whoever you are. God's saying, it's your choice. Addiction. Is it really a choice? Is it really something that we simply choose and we can go back to it, get out of it because it's just behavior, or is it a disease? Is it a disease such that we, when we fall prey to it, like cancer or multiple sclerosis or some other disease or disorder. Let's put it that way too, disorders again when it comes to muscular dystrophy and the disorders that cause that for the body and so on so forth. Is it a disease or disorder, or is addiction more to do with behavior, or is it both? We first go back to the theological and biblical foundations of understanding addiction, like we looked at in the last video. Back to the fall. Let's review in Genesis 3:1-15. So Now the serpent was more crafty than any of the wild animals the Lord God had made. He said to the woman, Did God really say you must not eat from any tree in the garden? The woman said to the serpent, We may eat from the trees in the garden, but God did say you must not eat fruit from the tree that is in the middle of the garden, and you must not touch it, or you will die. You will not certainly
die. The serpent said to the woman again, Satan reversing what God said. For God knows that when you eat from it, your eyes will be opened and you will be like God. It's your choice. Eve, it's your choice, knowing good, knowing evil. Then when the woman saw that the fruit of the tree was good for food and pleasing to the eye, and of course, mind you, she's at the tree, the actual tree, the knowledge of good and evil with the serpent in that tree. Doesn't really say that right away here, but that's what we can come to conclusion with and what a powerful picture, because she's right there. She also she she saw it was good for the food, pleasing the eye, also desirable for gaining wisdom. Whoo, although something I didn't know before, as if she wasn't already like God and she is so she also gave some to her husband, who was with her, and he ate it. Then the eyes of both of them were opened and they realized they were naked. So they see, they sewed fig trees together and made coverings for themselves. Then the man and his wife heard the sound of the Lord God as he was walking in the garden in the cool today, and they hid from the LORD God among the trees of the garden. But the Lord God called to mankind, woman and man, where are you? Daddy, calling out his kids, where are you? He answered. Adam answered, I heard you in the garden, and I was afraid because I was naked, so I hid. And he said, Who told you you were naked? Have you eaten from the tree that I commanded you not to eat from God, said. The man said, The woman you put here with me, she gave me some fruit from the tree, and I ate it. Just imagine if he was, of course, four years old. She did it. Oh. Then the Lord said to the woman, what is this you have done? The woman said, The serpent. He did it. He made me and I ate. I could just boy, if we could be a fly on the tree at that at that time, what it would look like. So the Lord God said to the serpent, Because you have done this, talking to the serpent, which, of course, God saw the whole thing. He saw right through Cursed are you above all livestock, all wild animals. You'll crawl your belly and so forth, eat dust and of course, die, and I will put enmity between you and the woman and between your offspring and hers. He will crush your head and you will strike his heel. Jesus Christ is going to come. He's going to crush Satan's head and also heal people, restore mankind to the woman, he said, I will make your pains and childbearing very severe. The painful labor you will give birth to children. Your desire will be for your husband and he'll rule over you. In other words, God in the love and logic approach, as we do with our kids, you know, option one, option two, option three, you choose. But of course, we'll stand behind whatever option you choose. Of course we set the options as as parents. Of course Andrew would, he would choose that, that first option most often. In our experience, some kids will keep on crying and carrying on, and don't go to option two or three. Where it gets worse? Well, it got worse here. And God said, You chose this. You chose it. And to Adam, he said, because you've listened to your wife and ate from the fruit, from the tree about which I commanded you, you must not eat from it.
Cursed the ground because of you painful toil, you'll eat fruit from it all the days you're like it will produce thorns and thistles for you, and you will eat the plants of the field as part of your bowel. You'll eat your food until you return to the ground. Since you're from it. You were taken for dust. You are to dust and to dust you will return. Other words, you will die. You will for sure. Or die, that's the consequence. That's what you chose, Adam, so you chose Eve. And what they did, of course, as we said before in our theological discussions with these videos, they opened the door. They allowed it Adam and Eve, not God allowed the sinful condition and state that we are now in to come and be and in fact, all of creation, all that we are as people, all that we we experience in the world, broken out of order, bad, separate from our relationship with God as it was from before, before, as we read in Genesis 1, Genesis 2, in perfect relationship with God. Adam and Eve walked with God the cool of the day. They walked and talked. They knew God's will, and how is it that they fell into this trap? But of course, that's a whole other theological discussion about the will and about choice. But for our purposes today, we want to get into the sight unseen things here, they chose it. It happened. Original Sin came in, and therefore our minds were affected and infected with this state of being separated from God. So on the one hand, you could say, Hold on a minute. Sure sounds like a behavioral model. Sure sounds like behavior because of being in the sin state. And if we choose to addict or to get attached to that one thing, whatever it is, whatever the drug of choice may be, because of our sin, true, but the same time, as we all know too, because of what happened sin infected and affected all of creation, everything around us, our bodies included and our minds included, to where we can fall prey to disease, to dysfunction and other things related to it and like it, and so we are not completely clear just yet about is it disease, or is it just behavior, or what is it when it comes to addiction? Well, let's dig a deep, a little further, and go to one more scripture, because everything comes out of God's word. It all does, whether it be thought, or course, creativity, anything, all that comes out of God, of God's word, we then come to apply in our world. So in Genesis 3, we we get, we get the foundation. Now let's go and fast forward to Jesus and how he addressed human behavior. Says, Jesus, course knew and knows how we think, how we are. He was there at the beginning. He saw it all he he knows. So Matthew 15, that which defiles, okay, so now I understand the foundations of brokenness and sin, and of course, how this plays out in terms of what, how we what we choose to do, the things that we do that we don't like, once we come to know Christ. And so Christ says this to the Pharisees in Matthew 15, starting verse 1. Then some Pharisees and teachers of the law came to Jesus from Jerusalem and asked, Why do your disciples break the tradition of the elders? They don't wash their hands before they eat the Pharisees were looking at behavior, choice, tradition, culture, based upon the Torah, based upon the rules and regulations, they added to the 10
Commandments and so on. Okay, Jesus replied, and why do you break the command of God for the sake of your tradition? He countered, for God said, Honor your father and mother and anyone who curses their father or mother is to be put to death. But you say that if anyone declares that what might have been used to help their father or mother is devoted, quote, unquote, devoted to God, they are not to honor their father or mother with it. Thus you nullify the Word of God for the sake of your tradition. Thus you nullify it, you hypocrites, you actors, you you ding a lings. Verse 7, Isaiah was right when he prophesied about you. What did Isaiah say? These people honor me with their lips, but their hearts are far from me. They worship me in vain. Their teachings are merely human rules. A lot of evidence here, in terms of the sin condition and then thought, and then choice and then behavior. A lot of evidence, lot of support for the behavioral model of addiction. However, Jesus called the crowd to him and said, listen and understand. What goes into someone's mouth does not defile them, but what comes out of their mouth that is what defiles them. Then the disciples came to him and asked, Do you know that the Pharisees were offended when they heard this? Of course, Jesus is saying, Oh, no, they were offended. He replied, every plant that my Heavenly Father is not planted to be pulled up by the roots. Leave them. They are blind guides. If the blind lead the blind, both will fall into a pit. Peter said, explain. Explain the story to us. Explain this parable. Are you still so dull? Jesus asked them, don't you see that whatever enters the mouth goes into the stomach and then out of the body, but the things that come out of a person's mouth come from the heart, and these defile them, for out of the heart come evil thoughts, murder, adultery, sexual immorality, theft, false testimony, slander. These are what defile a person, but eating with unwashed hands does not defile them. In other words, Jesus is saying, Look, when it comes to the things that come on a person's mouth come from the heart. It's the heart problem. It's the hurt issue. It's the Fallen heart that's far from God, that does what it wants when it wants it right now, that loves the next shiny thing that says, Oh, I, I want that light bulb. And I don't care if I I don't hear what I want to get it now. And of course, just like a kid burning the hand, I want to, I want to just grab that wipe off and I want it. That's the life of the addict, whatever seems to be right in that person's own eyes, the choice comes out, the behavior ensues. But is that due to a disease we have? Is sin a disease, or is it just merely because we are separated from God, we just don't know, and we have ignorance until we come through the Holy Spirit, from the knowledge, through Jesus Christ, of what the law is. And Paul talks about that Romans 7, I would not have known what sin was until I read the law and sin sprang up in me and died. Paul is very specific about how things are quickened. Things are are alerted to our senses and and things our eyes are opened, and we gain clarity through the power of the Holy Spirit. Quite the opposite from Adam and Eve, or they thought they needed wisdom through the Tree of the Knowledge of Good
and Evil, which was a lie. All they needed was God, big questions. And it comes to that, that whole thing of disease and choice, because what often happens with the models of addiction, and well as we, as we work with people who struggle addictions, which, frankly, is all of us. We all have something, me included. I deal with trying to please people. I'm addicted to people pleasing you. What people think about, what how we are in relationships, and also, are they okay? Are they not okay? And I should fix the situation me. That is Mark. Should fix every situation around me, because that's what I have a credential to do. Dr Mark Vandermeer, I'm here to fix save the day. Oh, really, how am I the problem? How am I getting in the way of what God truly wants to do, where, instead of me trying to grab the light. God wants to shine the light in that person's life. Give you an example. There's a man named Jeff who I worked with in my early days in ministry, and he was found in his pickup truck covered in his own vomit because of too much drinking. And as he and I just come on the scene, on staff at that at that time, just after my son, Andrew, was born, 22 years ago, and after Jeff was discovered, and also went to the hospital, and they helped him to get to a healthier state. I got to know Jeff pretty well. I got to work with Jeff quite a bit, and he was very grateful. He truly is a success story. So God saved him, and that's the real message here. God saves we don't but in Jeff's experience, he taught me early on, more and more about the experience of the addict. So as we think about how addiction works, what are the models of addiction? What are the constructs, the conventions of addiction? To better understand the addict, himself or herself, we first have to meet the addicts. Who are. They've been deep into it, deeper than maybe you or me. Although we all have something like I said, we fall into our own traps. But more importantly, as we look at a situation like Jeff, where it's more acute, it's more severe, Jeff came around and he said, Yeah, yeah, Mark, I'm a liar, I'm a thief. I'm a cheat. I'm the one who's who's the problem that made an impression on me. Jeff, tell me more about this. You You admit that, and also what he ought, what he taught me, and then also others, as I got more into doing with recovery ministry, which is my, my main focus today in ministry, is that it'll be either jails, institutions or death that a person who has gone deep into the path of addiction, but it's so severe that they can't seem to turn back, they can't seem to to shake it, they can't seem to get the help that they need if they keep falling back in. It's like getting out of the pool. Oh, man, glad I got out of that, and then, oh, falling back in and almost drowning again, needing a hand up to where all we can do is go like this. You know? I mean, because we're so weary of trying to tread water that we reach up, and God's hand pulls us out again, and God uses people to do it. That's why we're studying this. That's why you're going to this class on the how to break the addiction cycle. We first have to understand again. First video, what addiction is. Second video, the theology of addiction, which we had more we spent more time looking into the theology and the biblical worldview on it. And this video,
we're going to get into the models, because Scripture does support understanding all the models of addiction, they're all valid. Because, in my opinion, and after 20 plus years of working people in addictions, I can honestly tell you today that all the models need to be understood, because they all work together. There isn't just one model to bank on. Consider saying, This is it? It's the disease model all the way, or it's a behavior model, don't you know? No, it's both of those and others. Let's take a look at the models of addiction. As it gets set up here, start to think about your life. Some think about, yes, you're aware of your sin, but more aware of your patterns. What are your patterns? Patterns of sin, patterns of things you keep, you keep falling into the pool of sin. Let's say where we're we tend to drown in our sorrows. We tend to drown in our choices. Think about that because as we look at these models, it will help us to see more clearly what these patterns tend to be and what they tend to do in you. Because quite often, and I double this. Yesterday, I was seeing a wife of an addict, and her story was epic, epic. Her story was textbook, with the journey. Today, she's 60 years old, and back when they got first were married and having all three of their children, all boys, and dealing with not only addiction, but also mental illness and also other disability issues that popped up along The way. She said, My husband needs your help, Dr Mark, because we've gone everywhere. We've had marriage counseling, we've had this, we've had that. We tried everything, and he's still addicted to his painkillers. Bad back, bad situation. And I asked her, I said, Oh, call her Jane, as I said, Jane, so you mean to tell me, Jane that he doesn't see it. You mean to tell me that he denies the fact that he's got a problem. Oh, she said, You, you, you understand. I'm glad I do, because she went to the church, she went to other Christian counselors, she went to other people, places, things, and they told her to pray about it. They told her, which is not bad, don't get me wrong. They told her, Oh, it'll be okay, yeah, we'll pray about it. Well, you know, is back all what we call enabling behavior. And I finally, or she finally, rather, came to our place at Community Recovery, of which I'm executive director, and then I work with a lot with, I've worked with hundreds of people over the past 20 some years, and the same thing is true that the first step in recovery is to is to admit and surrender that you are powerless over Your addictions and compulsive behaviors. And I said to her, Jane, your husband doesn't see it. He's in denial. And all sudden, the light bulb went on, and God shed light into a process. I And again, nothing, no guarantees. God saves them. I don't. But finally, there was a connection with God and His people, between Jane and myself yesterday, at least at that point, and our hope for John. Let's call him his name, John. It's not his real name, but John will come forth at a future date, working with me one on one, and then going to groups with recovery ministry, with community recovery here locally in Grand Rapids, Michigan area, and then he'll discover what is really going on inside of him, inside of again, as we read in Matthew 15, inside of the heart. The heart, because truly, it's a matter
of the heart and where the heart is, that's where your devotion lies. And also we can look at behavior because of the sinful heart, but also at the all the disease, if you will, of sin itself and how it all hangs together, models, models of addiction. Well, let's look at the definitions first, drug use. Drug use, taking a psychoactive
substance for non medical purposes, out of curiosity. Of course, for the example I gave about John a minute ago. It had to do with necessity. Why? Because he had back pain that was severe, and yet that pain could be managed differently, rather than with a psycho active substance. And for him, it was oxycodone, opioids. In other words, drug abuse, drug use that leads to problems, loss effectiveness in society, which we're going to get to in a future video here. And behavioral cycle, psychopathology, criminal acts and the like drug dependence, a maladaptive pattern of drug use leading to clinically significant impairment or distress associated with difficulty in controlling drug taking behavior, withdrawal and tolerance. In other words, as we learned in our previous video about the addiction cycle, which we're going to look, look at in the next video, more deeply, more detail about the cycle of addiction, and learn from God's word, again, how the cycle of addiction is, of course, nothing new, but understand how it works. And we look and say, Okay, there's a maladaptive pattern, as I said, pattern. What's your pattern? And also, as we look here about behavior, behavior, also withdrawal. We fall back into the pool because it can't handle the withdrawal of if we go, if we if we abstain from drugs. But also, when we look at withdrawal, we withdraw from society as we fall back into the pool and our body begins to tolerate it. In other words, we get into a pattern of using the drug, and our body gets used to it. So we want more. John wants more of that Oxycontin, that opioid, if you will, that painkiller. Because, well, Boy, I've been taking, well, five milligrams. Now I want 20. I think Jane actually said he's taking 30 milligrams right now. Pretty bad. And also here with drug dependence, it refers to a state of needing a drug to function without within, quote, normal limits. There are such things, as we say in mental health, functioning addicts. Others, they get down so bad, they're so deep into the pool that they can't get out and they can't function at all. Well, the nature of addiction, again, a continuum of use. We look at experimental drug use just so we can review these terms circumstantial drug use. Both work together towards this causal drug use, causal curiosity. Let's experiment. Try out this. LSD, let's try this cocaine. Ooh, crap that looks interesting. Or, Boy, those painkillers feels good. Now circumstantial drug use, the circumstance, back pain, okay, use the painkiller. I want more that leads to the causal drug use that leads to the intensive drug use that leads to the compulsive drug use. Gotta have more, which leads to the addiction. I can't live life without that. What is it? What is that that is controlling your life? And then we look at motivational strength as this is a continuum, and also looking at motivational toxicity, addiction is more than mere drug use, the DSM-IV, the Diagnostic Statistical Manual number four, criteria for substance dependence, a
maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three or more of the following occurring at any time in the same 12 month period. Tolerance. Withdrawal, substance taken in larger amounts or over a longer period than intended, persistent desire or unsuccessful efforts to cut down or control substance use, great deal of time spent in activities necessary to obtain substance use, use substance for example, chain smoking. And as I've worked with people for years and years, smoking is the hardest addiction to stop and also or to recover from effects important, social, occupational, recreational activities given up or reduced because of substance use. And finally, substance use continued despite knowledge of persistent or recurrent physical or physiological, excuse me, psychological problem likely to have been caused or exacerbated by substance so we have a lot of good research here that we now can begin to frame, frame it in these models of understanding what addiction, how it works, in order to break the cycle, eventually, by God's Power, physical versus psychological dependence, you have physical dependence, the body becomes begins to tolerate those opioids, as far as withdrawal symptoms and the absence of the drug those they would call the detoxification so someone decides to abstain from from the substance, whether it be Alcohol, let's say, or, of course, those pills or cocaine or whatever the body begins to flush out all the impurities, and that, of course, relates to sweat, vomiting, and also other things that has to do with those kinds of Withdrawal symptoms, tolerance to its effects with repeated use, as we said, and also psychological dependence, a relatively quote from Altman et al, a relatively extreme pathological state in which obtaining, taking and recovering from a drug represents a loss of behavioral control over drug taking, which occurs at The expense of most other activities and despite adverse consequences, we'll say it again, a relatively extreme pathological state in which obtaining, taking and recovering from a drug represents a loss of behavioral control over drug taking, which occurs at The expense of most other activities, and despite adverse consequences, I got to have it. In other words, I can't live life without it, or a person will, let's say this is a bottle of gin, and we're pouring it in again, and we don't even realize we're doing it and taking a drink. Oh, gotta have more. And so it goes. We don't even see it. We call that denial. Also, it's a situation where drug procurement and administration appear to govern the organisms behavior, and where the drug seems to be to dominate the organisms motivational hierarchy. In other words, and this is a fancy explanation, if you will, to say, Well, gotta have more. Gotta have more. Because it goes from this to this, to this, to the brain, to the body, to Oh, the dependence and I can also, course the tolerance, and also where we say, my life is this, How sick is that? We are sick as our secrets, we are sick as our dependencies. Classic models. Here they are, model emphasize causes, examples of interventions. Now interventions, they are done, but are not always effective.
Why? Because, as we just looked at the psychological and physiological physical that therefore effects, affects, effects of the addiction, whatever that may be, opioids, alcohol, crack cocaine, or even work, or even sex, as well as codependency, people, placing the things I fix, everybody but my. Self because if I fix other people as an enabler, as a co dependent, I'll feel good, but you don't address your own issues. Well, here we are, the model, the moral model. The moral model says the emphasized causes are personal responsibility and self control, as far as interventions, moral suasion, social and legal sanctions. So when it comes to addiction and morality and violating law, violating morals, can we look at the sex problem, adultery and other crossing the line, criminal sexual conduct. There are sanctions that then are tried. And of course, it goes back to the heart, as well as family of origin. As we looked at this before spiritual we looked the spiritual defect, and we also go back to the moral as it relates to the spiritual why? It kind of goes back to the exist. The arguments for the exist, existence of God, one of the arguments for the existence of God has to the moral argument. The moral argument says that we, intrinsically inside of us, are moral, or we have a conscience. We have that sense for right and wrong, and we need to have moral structure, a right sense of right and wrong. For example, When we drive down the street, we then eventually come to a place where we have to stop. If we don't stop, we get hit, or we may not get hit, but we may get caught, and we get caught by the policeman who says you did not stop, or the police was not there, and we don't get caught, but we can build a pattern of this, of running a red light or running a stop sign. There are moral limits, boundaries. Lanes on the highway, stay in your lane. If you go over to the next lane without looking, we get hit so with moral and with the existence of God argument, of course, we know there is a God that the God the Bible, exists because there is morality has been instituted, the 10 Commandments, law, therefore, and also justice. Justice, because that's also the sense of justice as well. Now it comes to addiction, and you're going into you're trying to figure out, well, how does this person who is so caught up in their alcohol or caught up in their drug, caught up in their whatever they're doing and crossing a line morally, do they even see it in such denial and and, quite frankly, no, they don't. And so they get they tend to violate the moral and also they violate the spiritual. They break God's 10 Commandments. And that's why, in traditional Alcoholics Anonymous, and also traditional Narcotics Anonymous, and also now in other very variations, iterations of recovery itself, because recovery groups, and, of course, now recovery ministry, that has started to start to catch on the past 20 years, even more so, although really the past 30 years, but even more so in the past 20 and counting. We acknowledge in those circles that there's a spiritual defect, a defect of character. And here we look at prayer and also 12 step faith based treatment, which of course, refers to Alcoholics Anonymous. So the moral, the spiritual, temperance, aha, control of supply calls for abstinence, as it relates to
drugs or the abstinence, and also, therefore the promotion of the non use, the disuse of the drug of choice. And then the other model of addiction understanding and how we intervene. And also look at the breaking thereof of the addiction cycle of the educational Well, the addict must be just ignorant. They just don't understand about alcohol and effects or the thing of cocaine or the pattern of behavior. When it comes to work addiction, they're always up at the office all the time, while they're ignorant. It. We need to educate them. You don't do this. This is what you do. Do you balance your time. You abstain you. This is what the properties are of alcohol. The properties are cocaine. This is what happens when you spend too much time at the office and your wife runs off with somebody. Hence the needs of each husband or wife were not met eventually, and something happens. Something happens, conditioning, classical operant conditioning, counter conditioning, extinction is referring to in psychology, of course, to the skinnerian model, in other words, that our minds are then trained to certain habits and also cues to behaviors, also similar to Pavlov, but Pavlov's dog, when He would ring the bell, the dog would come to the dish to eat, or to the the dish of water to drink, or in every time the dog heard the bell, or to the point of where, as Pavlov would keep ringing that bell that eventually the dog would Would he noticed, the dog would salivate, let's say the water and also food weren't there, but the dog was saliva, because the bell would then trigger the ear of what the dog heard, triggered the brain, which triggered the salivary glands. Same thing with us conditioning. We're conditioned. And this which also leads to a conundrum at times with people, because they tend to think, they tend to gravitate to this view, world view, that we're all conditioned to certain behaviors. How can there be a god when we're just we're just creatures of habit, creatures of who are conditioned to do certain behaviors, which, of course, that's not the truth. Truth is God's created us and give us reason minds and so on, but we still have our issues with addiction and also sin. Okay? So moral, spiritual, temperance, educational and conditioning, other models, biological. Well, again, here we go. It's a disease. Maybe, is it? Well, we do look at the biology of people. We do look at the brains of individuals, and they come to determine that there are genetical or genetic arguments that are valid that point to if dad had a problem alcohol, most likely the kids will if there was another family member or other family members down in before your children that had problems with addiction and it ran in the family. Look out. Genetics. Do not lie. It is passed on, heredity, brain physiology, self medication, risk identification calls for abstinence and medical treatment. I would also advocate I would insert in there psychological treatment and again, leads to the psychodynamic model, personality defense mechanisms, psychoanalysis, psychiatry and or, of course, you know, Christian counseling, Christian psychiatrist, Christian counselors that can Help us through, in addition, family dynamics, family dysfunction, family therapy, along the same lines as in
psychodynamic but in group, social learning, modeling, expectancies, positive role models, rational restructuring of expectancies. To me, it sounds like the church. As you look at this model objectively and then apply it in context. It refers to how the church can be that place, that environment or social learning, that can be biblical in nature, that can be Christ centered in nature, in atmosphere, environment, it can reinforce better behaviors, biblical behaviors, Christ like behaviors, that is, and then change the mind and the heart, which we'll get into more discussion later. And here on this slide, finally, sociocultural, environmental, cultural, economic, social policy, social services, mental health. In other words, because the society, the community, is saying we need to do something collectively as well as individually, so that we can also address the family address families and address the community at large, well physical dependence or withdrawal model, a negative reinforcement model. This negative reinforcement model is that where some drugs produced physical dependence and withdrawal symptoms upon cessation of drug taking, withdrawal symptoms are produced by the body in order to compensate for the unusual effects of the drug, and withdrawal symptoms are generally the opposite of the effect produced by the drug. Let's say this one more time, some drugs produce physical dependence and withdrawal symptoms upon cessation of drug taking, withdrawal symptoms are produced by the body in order to compensate for the unusual effects of the drug. And withdrawal symptoms are generally the opposite of the effect produced by the drug. As I said, earlier, sweats, alternate, shaking, vomiting and other reactions at the body as if you have the flu or you have something else going an infection, that is that has to get out of the body. And also, addicts continue to use drugs in order to avoid withdrawal. They don't like the detoxification symptoms. They don't like all that, that struggle, and, of course, the ill effects. So they go back to the pool. They want to die in this manner. They say, Oh, I don't like all the DTs, as we call the detoxification effects. Now, I don't want to get sick. I can't handle it. Oh, oh, that pool looks so good. Oh, my goodness, it's like a hot day in summer, 98 degrees and sunny and very hot, and that pool water is looks so good. Or maybe the pond water to pond or or the lake, and they say, I'm going in and boom, they dive. Finally, over time, drugs no longer have the same rewarding effects. They merely allow the person to feel normal. Hence tolerance, hence, I keep doing it. Hence, it's it becomes a part of you, kind of like how the cell phone, yep, yep, okay, notification, okay, yep, the phone becomes an appendage of your hand, of your arm. We're so addicted to it. So maybe that's your addiction today, I don't know, but here, over time, drugs no longer have the same rewarding effects. Makes you wonder if they may may take our cell phones and just engraft it into our bodies. Oh, mark of the beast. We don't know. Just kidding. So inadequacies of the withdrawal model, inadequacies. So we look at withdrawal this negative model, if you will. Now all these drugs generate withdrawal symptoms, cocaine,
amphetamines, different drugs produce different withdrawal symptoms with different neural bases. In other words, this whole model of withdrawal, oh, just stop it. Just stop using the cocaine. Just stop using the alcohol. Hold on a minute. Every situation can be different, lot of similarities when it comes to intervening in the person's life and helping them when they are they've hit the bottom, and they are looking at saying, All I need is you, God, and they finally surrender, okay, but different drugs produce different withdrawal symptoms, and what's dependent, you should continue taking that drug for a minute, but some spontaneously stop, Okay? And unless drug abstinent users should not replace or relapse. Excuse me. Let me say that again, once, drug abstinent users should not relapse, since motivation has disappeared, but they do. And finally, no explanation as to why people take drugs in the first place, no explanation. However, what we do know through study, observation experience is this something isn't right in the person's life. There's a life issue. It's not about the drug. It's about the life issue, and what the person is trying to do to address the life issue, and we have the positive reinforcement model. Drugs produce pleasure and a high, and some drugs provide indirect positive incentives. They disinhibit behavior that's normally suppressed. Of course, you have alcohol, and if too much. Alcohol is ingested, and they lose their inhibitions, they get into situations where they will regret it later because they don't remember what what happened due to the hangover and due to then what happened last night? As we see in many movies, I'm sure, for that that occurs and you just shake your heart saying, what on earth? But welcome to human behavior. Also too. Most drugs of abuse stimulate the brain's reward circuit. It stimulates the dopamine levels and the pleasure centers with hypothalamus. All known drugs of abuse stimulate release of opioids in the nucleus acumen, acumens, and also animals will work to micro inject drugs of abuse and electrically stimulate the same parts of the brain as we, as they've learned in experiments and normal rewards, food, drink and sex, also stimulate that, that release. Okay. Now as we look at the the animal experiment, they would do the infusion pump into the into the rodent, you'd have them, they've been going to this whole thing of self administration. And also notice that animals work for reinforcing the drugs, IV, oral, inhalant and, of course, schedule support a reinforcement, fixed and progressive ratio. So in other words, like what BF Skinner would say, they get used to it. They there are certain things that get programmed and conditioned and they want more. And also with a lever, you know, saying, Okay, let's do it again. Okay, let's do it again. Okay, okay. And therefore you see the increasing self administration of morphine by a monkey, for example, as far as the the in daily intake, from zero to 60, if you will, in just again. This that steady pace right up here. And of course, the trend goes this way it it stays constant, and of course, then you have the reinforcement and the tolerance. Here again, the brain. You have the the canola, you have the electrodes reinforcing brain stimulation. Ventral tegmental
area, mesocorticumbolic system. The brain receives that stimulation. It gets reinforced, releases dopamine in the nucleus, acumen, and therefore, physically, our brains become connected to that alcohol or that substance to the point that it needs more drugs there and are and are not self administered by animals, alcohol, amphetamines that they found, barbiturates, caffeine, cocaine, nicotine, opiates and procaine and PCP. In other words, this selection has to do with human consumption THC as well, and these other ones, and go to drug dependence among every users. Tobacco, as I said earlier, is the toughest to get out of, to kick to abstain from. And of course, we have people who are the first percentages in a society the best of our knowledge, least American society here, of course, it could have, I'm sure it's maybe higher percentages where you are, I It's hard to track all the time. But here we have a good sample, a good understanding with our sample. So tobacco, most used heroin is right behind it, cocaine and then alcohol, other stimulants after that, and marijuana behind that. And again, it may be different in your community, wherever you are watching this video, the opponent process model goes like this, drug use initially motivated by positive reinforcement over time, tolerance to rewarding effects, but abstinence leads to withdrawal, and drug use ultimately maintained by negative reinforcement. So again, we we look at how you have the first exposure to later exposure, and the response from the rush to the it goes down, of course, after the high, big high, big low and need more. Need more current traditional view based on opponent process model, initiation of drug taking is primarily driven by anticipated pleasure. Facilitated by peer pressure, social facilitation, curiosity, ah, yes, behavior. And then, of course, for most drugs, pleasure becomes primary motivator and drug craving becomes cued by drug related stimuli. For some drugs, alcohol, cocaine, heroin, pleasure is enhanced by reversing unpleasant aspects of normal life. And for some drugs, nicotine, caffeine, heroin, alcohol, drug taking leads to dependence and withdrawal, which adds additional motivation to continue drug taking habit and makes giving up difficult. Finally, this withdrawal state can also be associated with environmental cues and increases the tendency for relapse, relapse, and if you look at relapse and relapse prevention, it goes back to the heart. It goes back to the life issue. It goes back to the also to the dependency that the body has been created because of those other needs that have not been met. And we get into this understanding of now, the traditional view, based on the opponent process, model of how this all works, limitations of the this model drug withdrawal is much less powerful in motivating drug taking behavior, as far as again, how we intervene, how we try to break the cycle. Stress seems to be more powerful, and withdrawal symptoms are maximal within a few days after cessation of drug use, but susceptibility to relax continues to grow for weeks to months, and cues typically fail to elicit condition withdrawal cues, in other words, how to Help the addict with new cues, new levers, new triggers, new people, places and things,
as we say, it can get tough and almost baffling. So you're saying, Well, how can we do this, these models? Oh, my goodness. Well, at least we understand what the researchers have have come to observe, track and also interpret based on addict behavior and the whole addiction process, you know, physically and psychologically. But ultimately, it goes back to the spiritual. It always does the spiritual and how God rescues, how God again needs to intervene, going back to the heart, going back how Jesus did die, did rise from The Dead that his hand pierced, or the nail pierced hand that is goes to you, all of us who are in the pool of addiction, in the pool of sinful patterns and behaviors, and says, reach, as through the Holy Spirit's power, be able to reach for Jesus hand and he pulls you up and pulls you out. Now I hope today that you understand there's a number of models out there, and how these models help to understand the person who is deep into their addiction, and perhaps well yourself, how that addiction is an issue in life, but with God's help, that Jesus said Matthew 15, we can, in fact, with God's help, As we ingest so the drug ingest God's word, thou, transform the heart, make us more like Christ, and be able to as we understand it, Do away with old patterns, with the old nature, II Corinthians, of course, chapter 5:17, the old is gone. The new is come and coming one day at a time and one moment at a time. Thanks.