Video Transcript: Lesson 7

It was my first day as a case manager. I was hired at community  counseling centers of Chicago. And as a case manager, my responsibility  was to manage a caseload, a list, a group of mentally ill people, people  with many disorders, behavioral, psychological, etc, all the above, and all  of the other things that go with it, including the fact that many cannot live  on their own. They need support. They need help. The clients that I was to manage as a case manager were living in the community, but they needed case management services. This is in the city of Chicago, and you have a  lot of different dynamics going on all the time, of course, in the big city. But my first day, my colleague of mine, who was there to walk me through my  my first day into my second day and first week so I can get on my feet,  brought me to a discharge meeting. Now, the discharge meeting was very  interesting. It was interesting because I wasn't sure what to expect. Of  course, be on the first day you never know what to expect. So we arrived  at the psychiatric hospital on the north side of Chicago, and as we came  in, we sat down and, and we said, okay, and then we sat with the person. I don't remember his name. This was 27 years ago, and we were talking  more with him and and, and the reason why he was being discharged from case management services from community counseling centers of  Chicago, was the fact that he had some very definite ideas about what  was going on in his world and His reality. So we were going over a  checklist. We got to talking with him, and then at some point, Tom, my  colleague, who was his case manager of this gentleman, asked him, point  blank now, who told you that sharks were going to come out of Lake  Michigan and get you well, the soap did. And the soap was telling you that  the sharks are going to come out of Lake Michigan to get you, yeah, they  really it did okay. And we then concluded the discharge process, and went  on from there. Now it may seem pretty funny to you, and it was kind of,  honestly, it was quite humorous to me, and funny and how the world, does a person think that sharks are coming out of fresh water, a fresh body of  water, Lake Michigan, here in the Midwest of the United States of America, and come after a person makes no sense. And obviously this gentleman  had a lot of issues with his mental health. He was mentally ill. He was on a lot of different medications, but also what was, in his case, profile, was that he had a lot of other addictions and other compulsive issues, addiction,  psychology, the psychological effects of addiction. That's what we're going  to talk about today, and we're going to walk through some of the things  we've walked through before, just to kind of get our get our grounding here when we look at the psychological effects, but in general, we're gonna look at at just what is involved in the behavior of an addict. And what we often  find is that with with addicts, is that. And of course, as you're watching you  may we all have something. We all have something we get addicted to. 

Maybe it's something small, like something some obsessive compulsive  behavior you have or or something else you got to have a cup of water in  a red cup. And that's that. And we've touched on these things before. But  what's interesting with the psychology is that as an addict, which we've  talked about before, gets attached to that. It that thing, that person, place,  or thing they got a. They want. What they want they want now, it's got to  be Now, if I don't have it now, there's a sense of urgency, urgency, oh, I'm  around grandma, ooh, she reminds me of of what other people think of  me, and oh, I feel then bad. And therefore that leads to anger that's turned  inward, which is depression. And therefore I want to go drink or I want to  smoke crack cocaine, because that will make me feel better. The brain,  the mind, powerful, great effects and affects when it comes to what  happens as we we get exposed to different people, places and things as  we think we need something when we don't and well, the mind and the  and the heart are affected by the whole Chemistry of addiction. So let's  walk through this and well, Nuance again, many of these things that that  come up when it comes to I want, what I want, when I want, it, the  urgency, the different effects of of where, if I don't have it, I cannot  function, and therefore I am not well, and I might as well just die. And as I  said before, when it comes to people caught in addiction, that's active  addiction, they'll either they either will find themselves in jail, an institution  like the gentleman I talked about, who thought the sharks are coming out  of Lake Michigan, or death, jails, institutions or death, eventually, and yes,  as a person uses a substance, uses or uses, even in behavior. It affects  the mind, how the person thinks, behaves and also carries on with life.  Okay, here we go, facts about addiction and treatment, treatment. And we, of course, looked at what addiction is. We said, okay, yeah, the brain  disease, but with biological and psychological and social components. And does treatment work with us? It can, it does, but it becomes very difficult  because many of our people who we work with, and as I work with, people in community recovery, they come, they come, and then they leave. They  come, and they leave, and they go to the the psychiatric hospital or the  rehab, and it's in and it's out, and then they mess up, they relapse, they go back in for the 45 days, or maybe a couple months. Not enough. It's  baffling, cost effective, yes, in the long run. As far as treatment, of course,  looking at the disease model, again, with biological, sociological and  psychological components, here's a case study. 37 year old man lives with his wife, quote, unquote, and two kids. Often it's cohabitation. They may  be married. They may not be married. Inner City dropped out of 10th  grade skilled worker. His parents are substance abusers. This is a  common theme, and we looked at this before 10 years heroin use, IV and  intranasal cocaine and alcohol, one treatment, detox six years ago, with 

this gentleman, 15 years incarcerated since age 15, he was busted for  possession, intent to distribute, armed robbery, third degree sexual  offense. He wants help. I can't keep living this way. Yes, I need the coffee.  I need the water. Got to be the red cup. It's got to be the white cup with the coffee decorations on it. And if I don't have it, I can't go on. I must smoke  the joint. I must get into the whole behavior of prostitution, my mind, my  brain, tells me I need to do this, but it come to a point where you can't  keep living that way. Goes back to the story at that I told you about the  previous video about this couple of whom the dad signed off his daughter  and said, Here, take her, because I'm in a place where I can't keep going  on I and, yeah, I need the cocaine and, and I'm making good money, and  mom's in jail. Addicts, hopefully, and this is their salvation, psychologically,  come to a place of surrender and look at the steps of recovery. The first  step is I admit that I'm powerless, or my my addictions and my compulsive  behaviors and my life has become unmanageable. So mentally,  psychologically, an addict has to come to that place of complete and utter  surrender where they can't go on at all as their salvation as a first step  towards God, Christ and salvation, spiritually, and it's all spiritual, but also  then psychologically, salvation, and salvation, sociologically and socially  and also physically, to stop, to then abstain from using the substance of  choice, or stop from the behavior of choice so it won't become self  destructive. Well, the nature of substance abuse. I love this cartoon, if you  can see it here on the screen. The caption is with these two guys on the  street. One guy is drinking coffee, the other guy is, of course, guzzling his  booze. That is none. That is not one of the Seven Habits of Highly  Effective People, and it isn't the 3c of addiction, control, early social  recreational use. So psychologically, we're telling ourselves, this is okay.  This is all. This is fine. I can have a cup of coffee, I can have a glass of  wine. I can have that beer. It's okay, because everybody is doing it, true,  control, eventual loss, though of emotional and behavior control, as the  person slides into the need for that beer or the wine or the other alcoholic  beverage or that smoking of the substance, they will lose emotional,  behavioral control. I gotta have it. I gotta have it now. I gotta have it all the  time, morning, noon, day, night, but at first seems okay because then  there are cognitive distortions, denial, oh, it's only one or maybe one more, and the person convinces himself or herself that's going to be okay and I  don't have a problem, or if I do have a problem, Yeah, I'll quit tomorrow. So they think tolerance withdrawal, tolerance and withdrawal with, with, as we look at addiction and control, tolerance, the body begins to tolerate it, and  we looked at the physiology of this before, as well as the withdrawal that if  the person goes quick, cold turkey, the withdrawal can be severe,  compulsion, from control to compulsion, the second C of addiction, drug 

seeking activities, craving it, like I said, got to have it. Go after it.  Something draws you, kind of like the person who, after work, says, I have to eat. I deserve it. I need to self indulge, and I will go to that McDonald's  go to the drive through because, oh, it's that long drive back home, even  though it's 10 minutes, I've got to go to McDonald's. I need my diet coke.  I've got to eat my cheeseburger and and, and it, it draws you the moment  you get in the car after a long day at the office or the factory or whatever.  Gotta have it. So maybe it isn't cocaine, maybe it's cheeseburgers,  continued use despite adverse consequences. Okay, let's say it's  cheeseburgers. How's the waistline? What does the scale say? How's the  blood pressure, cholesterol going up, and yet the compulsion says, the  body says, Oh, I got to seek this out. I need the 10th cup of coffee for the  day. Adverse consequences. I got the jitters. I can't go. To sleep. Now, I'll  admit it, I I love coffee, being myself. And just the other night, I thought I've got some other papers to grade for another class I'm teaching, and I'll  have I know it's 10 o'clock at night, I'll make a pot of coffee. At least have  good two mugs of coffee, it will be okay sure enough. At four in the  morning, I was up. I could not sleep. I was feeling the jitters it's hard to get  back to sleep and I was tired the next day. Should have known. Should  have known when it comes to caffeine, the drug of choice that everybody  says is okay, well, consequences, then chronicity, time, natural history of  multiple relapses preceding stable Recovery. Again, natural history of  multiple relapses preceding stable recovery. Sometimes it takes five times  10 times before coming out of that, that tolerance, that coming out of the  denial, where we're saying it's okay and and, and and, and we do abstain  from that coffee or from the cheeseburger or from the cocaine, and we're  doing okay for another day clean, another day clean. The time is one  moment at a time, one one day at a time, as we say in recovery. But then,  oh, it looks so good to go through that drive through. Oh, there. I know that guy walking down the street. I met him at the dope house. Yeah, another  Starbucks on the driving by, and they'll go, gotta have it. And then we fall  because whatever is causing, whatever is the root issue of the addiction,  family of origin issues, self esteem issues, pain, shame, hurt, and we think that that drug of choice is going To make us feel better if I only eat comfort  food, that cheeseburger, I'll feel better, and then your heart and your blood  pressure and the rest of your body revolts, chronicity, and sometimes you  have To fall in order to get up, and every setback is a setup for a  comeback. We say in recovery, it takes time to get through these things of  addiction, when it comes to the mind and the heart and behavior, and also  with again, years of sobriety, relapse is still a reality. Let's see. The issue is not necessarily the drug. The issue is about the root issue again family of  origin, but also the thing of needing control. Do I only have control over my

life? So you can you immediately see that this is a spiritual issue  psychologically, because I think I can be in control of what I do and also  what I say, and also over the consequences I may incur for using my drug  of choice. But see, I actually control, not abstinence. Abstinence again is  not it is one of our goals in overcoming and breaking the addiction cycle.  But it's not necessarily the issue. The issue is about control. If I can have  just one that I'll be normal, Says the guy here in the cartoon, just like my  friends, just like my people, the friends, perhaps that is, who are sober all  the time or cover it up pretty well control risk factors, genetics. I know this  personally because my parents, over the years have said, you know your  great uncle who was an alcoholic, we've been concerned about you, Mark, concerned that you will then pick up the drink, that you will seek out that  drug of choice and get caught and also go down the spiral of addiction and be in trouble. Thankfully, by the God's grace, I haven't but I still have my  co dependency issues. I still have my caffeine issues. I still have my my  moments. Genetics we all do, but genetics is a real deal. Many of the  people that we work with in recovery. They in fact, have moms and dads  who have struggled with this, just like the 37 year old man we looked at a  minute ago in the case study. The genetics do not lie. It does get passed  on from generation to generation. Primarily says the research through  parents to children. And of course, as we grow up, we say, my goodness,  I'm becoming like my dad. My goodness, I'm becoming like my mother. Oh boy. I married someone like my dad. She says, Wow, she's just like mom.  He says, it's true. And looking at the earlier age of onset when it comes to  addiction, I have unfortunately been in company with families where he or  she said, Yeah, Dad used to give me alcohol when I was three years old.  Or dad used to put little alcohol in my baby formula or whatever, because  in his mind, again, like the sharks coming out Lake Michigan, in his mind,  that is going to be okay, and it's not okay. Yeah, it'll help the tooth pain.  You know when you're teething as an as a infant, becoming a toddler, and  you've got the the teeth coming through, and the addict says, Yeah, this  makes me feel good. Put a little of that in the dish on the bottle. The  sooner that the kid is exposed to it, the sooner that the child is ingesting it,  the sooner it will be that he or she will engage and see in the body, then  will then need that drug of choice. Of course, if we look at childhood  trauma, violent or violence done upon the child, sexual trauma, sexual  abuse, and all forms of abuse which lead to blame, shame, hurt self  rejection, many psychological effects then will eventually lead, for many,  into, well, first of all, into the same behaviors, like with addiction to a  substance of your choice. Also we look at behavior. Research has shown  that when we look at behavior, if the abuser has a child, the child is  abused, it therefore logically follows that the child may well not always. I 

agree with you're probably saying, Oh yeah, not all the time. Hold on a  minute. I agree they can break that cycle. They don't. Does not necessarily mean that the child will become an abuser too, but often it does, or it may  lead into other problems that have to do with addicting to a drug of choice  because of what happened in childhood learning disorders, ADD, ADHD.  Attention span, hyperactivity. Attention span is this short, the child cannot  sit still and so on. Mental Illness predating use quite often, as I've seen it in the inner city districts of Chicago, Grand Rapids, Michigan, and other  places I've been to other parts of the world I've been to, mental illness  does often lead a person into an active state of trying to medicate what's  not right in the mind, with what's imbalanced in the brain. And quite often  when we deal with brain disorders, those who are schizophrenic, those  who are dealing with the, shall we say, paranoia, effective disorder, and as well as other disorders of the mind, they often think that, well, my  medicines are not working, so I'll use alcohol, or I'll use something else a  little more powerful, and I'll feel better and more functional. Not true, but  mental illness does play a part also too, depression, bipolar, psychosis,  ADHD, those are just examples. So we need to be aware that mental  illness, quite often, will lead that person to that feeling that they're out of  control. But then going back to the issue of control, need to feel like they  are in control when they are out of control, it's kind of like the biker who my dad and I, and I may have used this story in the previous session, but we  were at this diner at 11 o'clock at night, walked in. I was about 16 years  old, 17, got breakfast, sat down, and this biker burst into the diner, and  there was a table full of policemen not too far from the entrance, having a  break. And he said, I was about to raise hell out there. He said, till I saw  you cops. You policemen. I thought, you know, there's something going on. And so as he walked in, had his seats, I walked by him to get refill of  coffee. Yes, I was into coffee as a teenager, I admit it. And came back,  walking back with coffee, had a Jesus t shirt on. I was really into my faith.  And as the story goes, he looks up at my teacher. Says, I know Jesus.  Yeah, he's my friend, yeah. And I walked, sat down and had more time  with my dad, Father Son time. And then about one minute later, not even it felt like that same guy comes to the booth. Motions to me to move over  and sat with us because he wanted to, not, because we invited him to, but  because he wanted to had the whole thing, you know, leather jacket on, or actually, leather vest, leather cap, bloodshot, bloodshot eyes, and we  knew he was he was on some substance. He began to talk about his  travels around the United States and Europe and other places and and on  his mutt. He called it a motorcycle that was made up of different different  parts of different brands of motorcycle. You motorcycle enthusiasts, you  probably know what I'm talking about. And as he was talking about it, he 

just talked about his need for God, bottom line, why? Because, as the  story is applicable here, he was trying to say to us, I am out of control. I  boy, because he saw my T shirt with Jesus on it, and began to see that  psychologically, therefore spiritually, he did not have it all together. Big  surprise. So we look at the brain disease of addiction, but we also look at  the spiritual side of addiction too. Of course, we've seen this before with  the healthy brain and the cocaine in this example, cocaine addict brain,  the healthy brain. Of course, you see the coloring that gives you the  healthy brain. You see the lack of the coloring from the healthy brain to the sick brain. Prolonged use changes the brain in lasting ways. So with this  biker guy, as he's sitting there in the booth with us having coffee, talking  about his story, you could also see too that in his mind, in his brain, he just could not completely function. It's very similar to how I've been working  with another gentleman and his family and how things just don't add up  sometimes. Yet he's okay, he's functional, he's working full time and and  yet, things just don't add up sometimes, and there's always chaos  because of the prolonged use of the substance of choice has changed the  patterns of the brain and changed the thinking, changed the psychology of the person, no longer Balanced, but imbalanced. More examples for the  normal to the cocaine abuser. Of course, if you, if you were in class with  me, now, I'd go over these questions as far as the 3c and the true or false  addicts should only blame themselves for their addiction. They don't. Act  responsibly. Could that be true or false? I'll let you decide how drugs and  alcohol work. Of course, we looked at how they interact with the nerve  circuits, the centers, the chemical messengers. I feel good, euphoria and  reward. Okay, now this is getting into the psychology of what the drug and  substance does. So the psychology and the euphoria and the reward goes like this, I feel good. And the brain tells the person all over saying, Yeah,  this does feel good. I feel I'm in control, if you follow me. So I feel like I'm  in control. I feel good. That feels like a reward, kind of like at the end of a  hard day at work, I go to the McDonald's drive through, or go right into  McDonald's and go to that, that that place where you order and you get  the two cheeseburgers, maybe four cheeseburgers, cheeseburger  cheeseburger cheese. I got to have my cheeseburgers and my coke and  my sugar and my and and and, and, and the body says, Oh yes, this feels  good after you deserve it. You deserve it to make it yours. Today, you feel  like you're in a commercial on television, and your body says, Bring it on,  because I couldn't stand the boss, that coworker, she's a nag, and I'm just  not feeling right, and I'm not sure I'm going to stay at this job. Oh, eight  hours of misery. I'm going to the 24 hour euphoria center McDonald's,  that's right, or I'm going to the dope house where I can get my drug, or I  can go to the bar, because that's where the good times roll. That's the 

psychology. It's like Dr Skinner. How Dr Skinner and B, F Skinner is his  name, how he examined the rats, the mice that he would then stimulate  with this substance, that substance, and how the and how, every time you  would hit the button, or you would do one little trigger because of that  trigger, that mouse will then go back to the little spigots, where they'll take  the drink of whatever substances out and it feels good, and so on so forth.  How then the mouse was then conditioned to come to that little spigot to  take the drink, just like Pavlov, Pavlov's dog, famous story, ring the bell,  the dog salivates, goes to the food, takes a drink of the water, to the point  where the dog was so conditioned that you just ring the bell and the dog  thinks It's hungry. The end of a hard work day, the saliva glands kick into  gear, and you deserve it self indulge. No one will know, especially your  wife or your husband, your family. When you get back after you indulge at  McDonald's or at the bar, you cover it up. Why? Because it's a reward. It  covered. It makes the body feel better. Makes you feel better in your  thinking and your in your sight, in your sight, your psyche, you feel like,  Oh, I got and therefore you understand I'm teasing this out of it because I  want you to think about you and your experience, not someone else's, and a lot of us breaking the addiction cycle. This class is not only to  understand the social and psychological effects, but it's also to understand you as a Christian leader, who's human, who's broken but forgiven,  washed clean, ah, I feel good. I feel better again, reduces the negative  feelings so we think, ah, the caffeine, or this feels normal. This is a very  important point. I feel normal now. I feel I'm on top of the world. I feel I'm  functioning because I just had my five glasses of beer. If you remember  the famous TV show, cheers, Who comes in all the time, and they say hi to them all, Unison in concert, Norm, because norm would come in, sit at the  bar, and he would have one mug of beer and then have another mug of  beer, and then 10 mugs later, he still wasn't finished the body, so the  character, which would tell us the body could have more because it's  tolerating more, it needs more. He feels normal. Get the joke, Norm mole,  he's I feel normal. So the character of Norm felt in the TV show. Cheers,  so that this is how life is how life ought to be. And again, I'm sure you've  encountered people in their testimonies. I have as well who as they come  into recovery, saying, be in the dope house being strung out on on  cocaine, a guy named Dave from working right now he He says, Yeah, I  don't know what I was thinking when I was smoking cocaine in the in the  dope house. And my wife didn't know where I was. And I thought that was  normal. I thought that was life. Of course, he had marital problems. You  can just insinuate here, and he did, and why go back to the house where  you have the negativity? Well, I could be here and be among friends and  feel normal, and then yes, the craving, tolerating the effects. But you say, 

Boy, I, I can't go on like this, and and, and with cocaine, and the stronger it gets, the more stress in the heart, and then the feeling like you're going to  have a heart attack, as cocaine crack users have told me, because that  has not been my drug of choice. It's been their drug of choice, and they  get to the point again where they are. They do feel powerless, but they  need more to feel normal, to now feel powerless. The insanity continues,  and when they say, I can't do it, I must withdraw, abstain they begin to  withdraw. They feel sick. If they go into a detoxification center or detox for  short, often they'll be there, they'll be shaking, they'll be sweating like  crazy. The body is beginning to say, Okay, you're not feeding me that  substance to make me feel normal. Therefore I'm going to now flush out of my system from the shakes, the sweating, the vomiting, to the other  defecating, so that you you are absolutely miserable. But it has to happen  if the person is to step out of that false sense of normalcy. And of course,  here's the pictures of what happens in the brain. The dopamine spells  reward, ah, there's the release, the activation, the recycle, and it goes from there inside the natural rewards. Ah, of course. Look at food, sex,  excitement, comfort, pretty straightforward now, though, now that we've  unpacked this, the pathways the front prefrontal cortex, nucleus  accumbens, we've looked at this before, going right there in the pleasure  centers, and then activation, reward, how where things, different  substances go in different directions, cocaine, heroin, nicotine and to this,  this place in the brain Right here, alcohol over here, and heroin that way,  just does. That's not my area of expertise, but this is what we now know.  What we learn from those who have studied this scientifically, my specialty is into the behaviors, working with people as they are actively using or  they've detoxified and now they're in recovery. Here you have the  behavior, the psychology, the need for control. First, a rewarding behavior  becomes routine. Got to have it. I feel good. I feel like me. So he or she  thinks, the subconscious control the behavior. I can handle it. And then in  the red here, it is hard to extinguish the behavior, because you're realizing  you're killing yourself. People are walking away from you psychologically.  You're feeling alone and isolated and not always aware when it's when it  when it starts. The person resists change becomes the habit, the way of  life. Well, if those people are gonna walk away, I'll find new friends. But  you find friends who are just like you, or in the same spiral, the same  insanity status, and they will leave you too eventually, or they'll steal from  you, or they'll kill you eventually. Why? Because you're in that state of I  feel normal. I feel good. I need more drugs. I don't have money. I'll go steal the money. I'll steal the money so I can get my reward. So and this and the cycle continues, eventually, you will then borrow money from people who  are not trustworthy, and then they will get back at you, violently and even 

to the point of threatening your life and unfortunately, last week, a week  ago today, actually, I led a memorial service for a young woman, 38 years  old, who was at a party she's been what part of our one of our, one of our  families, at community recovery for years, from when she was very, very  young, now a grown woman, someone put something in her drink. She  ingested it began to not feel well and was passing out, and then someone  took a needle, shot her up with some another drug, and she was  becoming unresponsive, and they placed her in a bathtub to die.  Fortunately, she was discovered, but it was too late. By the time they  reached the hospital, she was pronounced dead on arrival, 38 years old. I  knew that the young woman since she was a little girl. It's hard, but by  God's grace, we work through the issues, the issues of together, as with  that family, we're working through the issues of, of course, denial and how  can this be, and and bargaining, all the stages of grief and just the intense  pain of parents burying their children, sobering so psychologically,  addiction leads to not only euphoria, a sense of reward, but also a deep  sense of loss. Well, let's look at the dog and the bone example. As we  study this a little further, it never wants to let go that bone, that dog, it bugs you until it wants what it wants, until it gets what it wants. And for those  who have dogs, I have a cat, so I can't relate as well, but I know I've  known enough people with dogs where they've said, yeah, it keeps on  coming to me and give me the bone. Give me the bone. Oh, or the toy, the toy, the toy, oh, I'm gonna go outside. Oh, go outside. I want it now. Of  course, it's funny when it comes to dogs, because dogs think you are God. As a cat person, the cat thinks she is God. So anyway, it's a funny story.  So the dog keeps bugging you. It never forgets when and where it is used  to getting its bone. It's always the same time of day, always again, a  promise, a reward, the threat of loss or the threat of punishment, that's a  hard day at work. Oh, and I don't get my drink and my four cheeseburgers  with everything on it and more sugar. I don't feel normal. So I can so I can't tolerate the boss the same time I got to have it. And it thinks the dog thinks it's going to get a bone anytime they do anything that reminds it of the  bone, anytime. Got to have it all the time you. Well, how does, how long  does the brain remember? Was the front of the brain, back of the brain,  how things are activated, and the brain things light up. But there are  memory problems, short term memory problems, short term loss, which  affects how we think, how we behave, impaired abstraction. Impaired  abstraction, for example, a person can't process a math problem that's  abstract if they're still in school, or they can't process that question of, well, how do you love somebody concretely? They could say, well, I'm there for  I'm there. Yep, I got her. I got her coffee, I I took her to, to the store. I love  her, but what is love? And answering that abstract idea of love or life, or or 

worldview, or, or these things that we learn here at Christian leaders  Institute there this the brain becomes impaired. Cannot process abstract  thinking and also preservation using failed problem solving strategies. It's  what we call the insanity button. I do different things as I hit the insanity  button to get the same result. It's not working. Also loss of impulse control.  And this is pretty straightforward, pretty obvious. If I'm drinking too much  alcohol, I should not be driving and hence we have laws today about  drinking and driving here in the United States, as well as the whole thing of cancer and other physical ailments that are caused by being addicted to  nicotine, which is, of course, legal, and now you have cigarette companies that are being forced legally to put big signs on their labels, and also at the store, smoking will kill you. That is Marlboro as one big example. As I fall  around the world, and I've gone and been the airports and and I've, I've  gone to their duty free shops and, and my first time I saw it a few years  ago, smoking kills. That was the big sign next to Marlboro boxes of  cigarettes that people could buy there in the airport. And, yes, loss of  impulse control. There's loss of control with with in multiple ways, in ways  we just discussed. I gotta have it. I gotta go to the drive thru. Gotta go the  bar. I gotta, I gotta, I gotta, I gotta, I gotta, and, and, and that's what is  controlling you now, and therefore there's no you having control over you.  And as we look at addiction, the first video that goes back to idolatry, and  also just the fact that I can't work my hands the way I want to, or I can't  think have good recall when I want to or or whatever, the functions the  body start to break down sooner than later as we get older. They're similar  to those with brain damage. Brain damage, of course, what it? What is it  that makes addicted people like drugs and alcohol so much euphoria? Of  course, alcohol is a common one related issues, of course, detoxification,  fetal alcohol syndrome, loss of judgment, that's a big one too, especially  when you're driving suicide, homicide, it hurts so bad, I got to drink more  DUI or DWI. Driving with influence, driving under the influence, poly drug  use, alcohol isn't enough. Give me cocaine. I wonder what this is going to  be like. If I put them together, they go. Many people go there legality  issues. You steal the money to get the drug you will you will be  incarcerated if you get caught commonly use or abuse Drugs, marijuana,  of course, we call that a gateway drug. It's the gate. Way to other strong  drugs, of course, lack of motivation, Arrested Development, memory loss,  long detection time. Legalization issues when it comes to marijuana in  terms of usage and legal and now in many states. In the United States,  marijuana is legal as far as having possession of it, but still what you do  with it and how it impairs your mind and so on, like alcohol, alcohol being  legal and so on, leading to problems and other other areas. Health issues,  cocaine and crack. High relapse for potential, high relapse potential, high 

reward. Again, the cycle euphoria to agitation, to paranoia. They're always  out to get me, don't you know? Yeah, to the crash, to the sleeping as well  as not eating, euthymia to craving, obsessive rituals, permanent paranoia  

eventually, because the mind cannot handle it anymore, no medications  are currently available to fight this and also increased risk to heart attack.  Meth, methamphetamine, high energy level, repetitive behavior patterns,  incoherent thoughts and confusion, auditory hallucinations and paranoia,  binge behavior. Gotta have it long acting with meth up to 12 hours strong.  Heroin, detoxification issues hard to get off of it. It's, as my friend had said, who he was. The biggest Nick for better was his name, Nick said, he said  to me in his book Nick and Gretchen, if you can find it there on Amazon, I  highly recommend it. It's his story. Nick Barbetta and his wife, Gretchen,  were kind of like a Bonnie and Clyde of the drug world for a while, and  they they just did it all, and their main drug of choice was heroin. And as  they trafficked heroin from Florida to the rest of the United States. And of  course, came from Central and South America. They were there in Miami  to pick up the road. And they became the largest, the largest dealership  and distribution at that time ever of heroin. And they were so hooked on it  themselves, they describe it as being a demon, a devil, something that  was spiritually personified, controlling them and how they thought,  behaved, what they did, what they said. It had to be about the drug,  intense withdrawal, physical pain, the craving and so on. New drugs, club  drugs, the mix the match, popular with youth and young adults. Of course,  it always is. Whoever's new it's part of the youth culture, they say, and it's  very true how it does come around. It comes through. The young people,  neuron destruction, ecstasy, usually they won't. They know how to reduce  the risk and the wrong and they use increasing. Their use has been  increasing for Oxycontin and also ecstasy and, of course, now opioids, so  common characteristics of people who are addicted, of course,  unemployed or employed. We've talked about multiple or no criminal  justice contacts, difficulty coping with stress and anger, another important  point, conflict. Can't handle it, paranoia. They're always out to get me, and  they lash out or anger about family of origin again and shame and blame,  and they feel the shame still their head, even though maybe mom and dad have forgiven them years before, it's still there, highly influenced by social  peer group or loner. Isolation is common difficulty handling high risk  relapse situations or craze excitement. And we touched on that already,  about how it got to have it got to do it now at the dog and the bone more  common characteristics, emotional and psychological immaturity, difficulty  relating to family, sustaining long term relationships, of course, education,  vocational deficits and violence, violence, alcohol, for example,  disinhibited aggressivity. See stimulants produce dose dependent 

paranoia, opiate seeking, but not opiates produce violence, because the  brain thinks something's going on and it isn't. What are the risks of  becoming addicted? Of course, at the genetics, the young age, learning  disorders, mental illness. And of course, what are the first and second  most craved substances? If you look back here in this presentation, one of the first, second and third most used substances. And of course, true or  false, addicted people are usually homeless, criminal, antisocial and older  than 26 now I'm going to jump in here and give you that answer that's  false addiction, and how it affects people is no respecter of persons, class  or anything. It affects all ages, all situations, all status, that is reality. There are also co occurring disorders. Each disorder affects the other and  changes the outcome of treatment. And now we look at our second case  study, a 25 year old single woman pregnant with one child. She has a  GED which is equivalent of a high school diploma. Wants to go to  community college, opiate, nicotine, alcohol dependent, depression and  anxiety since age 20, one suicidal attempt, multiple intense and brief  relationships, CWS, or that's coming from this material from another place, but it's also we call it Child Family Services here, and where the  government gets involved with the family and takes the kids away due to  neglect, close to parents and no female friends on the multi axial diagnosis we look at, and if we just look back, look back at this, at the case, at the 25 year old woman. Think about the dog and the bone. Think about the  insanity button. Think about how, like with Pavlov's dog, she needed it so  bad. Psycho psychologically, she was disconnected from her kid, and she  was she was becoming neglected. She was neglectful of other things in  her life. Nothing mattered anymore, but the drug. And that's where people  finally said, I can't deal with you anymore. So we look at, then these  diagnoses. We look at clinical disorders, like, of course, antisocial  disorder, also bipolar disorder and other disorders, also personality  disorders with mental retardation, medical conditions, psychosocial  factors, global assessment of functioning. In other words, how does the  whole person function? How is the choice of drug impacted this person  that's a bit dated, we look at 04 and but the question is, if teens abuse  specific substances, what's their risk of having mental health problems  here, if you can tell we have green, we also have blue and red. Low risk,  zero to four problems, medium risk in the blue, five to 10 problems, red,  high risk, 11 to 22 problems. So with the total admits, fortunately, we have  low risk being higher than the other two. But as you can see, you have the  medium and high at pretty decent levels. Marijuana, thankfully, low risk is  higher. Alcohol, the low risk is higher, but when it comes to alcohol,  marijuana, medium risk is higher, prevention of all of these things. Low risk is higher. May be different today, studies are still being done to keep up on

the latest. Of course, if teens abuse cocaine, what's the risk of having  mental health problems? Well, cocaine is different than alcohol, marijuana, based on this study, high risk, and this is probably representative, even  though it's 15 years old, looking around you, and of course, looking at at  for probably more recent studies and so forth as a common half the  process, we say, is probably going to be representative. So the high risk,  the cocaine total, is higher than the others are broken down, and we need  help. We do have issues. If teens abuse opiates, what's their risk of having mental health problems? High risk, high risk. Why do we need to do more  to help people with CO occurring disorders, more treatment, more relapse, more rehospitalization, more ER visits, more vulnerability, more violence,  more suicide, more homelessness, more arrests. Why do we need to do  more to help people with CO occurring disorders? Because one drug of  choice is not always the issue. Quite often with each person, something  else is going on mentally psychologically and also, therefore socially  globally, as well as more illness and earlier death, and also resistance to  resistance to treatment. And as Isaid before in this class, the church is the  hope of the world. The church needs to be there. The Church has to step  up as God's community, God's people, and get involved with people who  deal with disorders that are acute. But of course, as we all have  something, we need to get real and also begin to not stigmatize, to  destigmatize addiction of all forms. Now you have more understanding of  the nature of addiction, psychology, the mind as it relates to behavior and  also choices. From here we begin to the economic and other areas of  addiction as we look at breaking the addiction cycle in this class, thanks  for watching.