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T H E M A T R I X M O D E L B Family Education Group Handouts INTENSIVE OUTPATIENT ALCOHOL & DRUG TREATMENT PROGRAM Revised and ExpandedRichard A. Rawson, Ph.D., Jeanne L. Obert, M.F.T., M.S.M., Michael J. McCann, M.A., and Walter Ling, M.D
B Family Education Group Handouts DATECOMPLETED Session 1: Triggers and Cravings (video lecture) Handout 1: Triggers and Cravings Presentation Notes____________ Session 2: AA/Matrix Model Panel (discussion group) Handout 2: Panel Member Guidelines____________ Handout 3: Twelve Step Sponsors____________ Handout 4: The Twelve Steps____________ Session 3: Road Map for Recovery (video lecture) Handout 5: Road Map for Recovery Presentation Notes____________ Session 4: Avoiding /Coping with Relapse (discussion group) Handout 6: Avoiding/Coping with Relapse____________ Session 5: Families in Recovery (video lecture) Handout 7: Families in Recovery Presentation Notes____________ Handout 8: Helping Checklist for Families____________ (Advanced Stage of Recovery) Session 6: Living with an Addiction (discussion group) Handout 9: Living with an Addiction____________ Handout 10: Medication-Assisted Treatment Presentation Notes____________ u u u Handout 1 • Family Education Group Triggers and Cravings Presentation Notes Slide 1 B Triggers & Cravings Presented by Matrix Institute on Addictions UCLA Integrated Substance Abuse Programs Slide 2 Triggers Definition: A trigger is a stimulus that has been repeatedly associated with • preparation for or anticipation of alcohol or other drug use • the use of alcohol or other drugs These stimuli include people, places, things, times of day, emotional states, and secondary drug use
Please use white space to take notes
THE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 1 of 23 Handout 1 • Family Education GroupTRIGGERS AND CRAVINGS PRESENTATION NOTES continued Slide 3 Triggers and cravings for Stimulant Users people who use stimulants— in order by most frequently reported triggers and cravings Triggers and Cravings for this class of drugs
• Alcohol Use • Drug-Using Friends • Environmental Cues — Money — ATM — Freeway Exits — Neighborhoods • Stimulant/Sex Connection • Boredom Slide 4 Triggers and cravings for Opiate and Heroin Users people who use opiates or her- oin—in order by most frequently reported triggers Triggers and Cravings and cravings for this class of drugs
• Stress • Secondary Use of Alcohol or Other Drugs (AOD) • Analgesic Use • Anhedonia/Anxiety/Depression • Environmental Cues • Discontinuation of Treatment, Self-Help Groups, NaltrexoneTHE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 2 of 23 Handout 1 • Family Education GroupTRIGGERS AND CRAVINGS PRESENTATION NOTES continued Slide 5 Triggers and cravings for people Alcohol Users who abuse alcohol—in order by most frequently reported triggers and cravings for this class of Triggers and Cravings drugs
• Negative Affective States— Especially Anger and Depression • Discontinuation of AA Involvement • Social Availability of Alcohol • Relationship Disruptions • Situational Issues — Happy Hour — Airplane Trips — Holidays Slide 6 Triggers and cravings for people Prescription Drug Users who abuse prescription drugs— in order by most frequently reported triggers and cravings Triggers and Cravings for this class of drugs
• Extended Withdrawal Symptoms — Insomnia — Anxiety — Panic • Alcohol Use • Pain • Doctor’s Offices, Pharmacies, Medicine CabinetsTHE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 3 of 23 Handout 1 • Family Education GroupTRIGGERS AND CRAVINGS PRESENTATION NOTES continued Slide 7 Triggers and cravings for people who use marijuana
Marijuana Users Triggers and Cravings • Anxiety/Irritability/Insomnia • Using Friends • Social Situations • Paraphernalia • Liquor Stores/Head Shops • Concerts Slide 8 In 1904, I. P. Pavlov, a Russian scientist, received the Nobel Prize for a series of experiments he conducted on the physiology of digestion that later came to be known as the principles of classical conditioning
I. P. Pavlov (1849–1936)THE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 4 of 23 Handout 1 • Family Education GroupTRIGGERS AND CRAVINGS PRESENTATION NOTES continued Slide 9 Pavlov would feed dogs and ring a bell at the same time. The dogs would see and smell the food, which would trigger an automatic reflex, causing the dogs to salivate. After a while, the bell would be rung without the presence of food, and the dogs would still salivate. The human brain responds in the same way to drug and alcohol triggers, producing cravings even in the absence of alcohol or drugs
Pavlov’s Dog Slide 10 If you release a caged mouse Place Preference and it has the option to run into a well-lit or dark area, it will Potency of Reinforcing Effects of Cocaine always run into the dark for protection. This is an ingrained survival mechanism. If the mouse is given one dose of cocaine in the light, the next time the mouse will automatically go into the lit field, thus reversing the con ditioning that took place over millions of years. This demon- strates the power that drugs have to grossly distort normal brain chemistry
THE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 5 of 23 Handout 1 • Family Education GroupTRIGGERS AND CRAVINGS PRESENTATION NOTES continued Slide 11 The brain controls our physical sensations and body movements
The brain controls our sense of balance and coordination, as well as memory. The brain also controls our feelings of pleasure and reward and our ability to make judgments
The Human Brain Slide 12 When we feel good, for whatever reason, the brain’s reward system is activated. The reward system Natural Rewards is a collection of neurons that releases dopamine, a neurotrans Elevate Dopamine Levels mitter. When dopamine is released by these neurons, a person feels Pleasurable activities, pleasure
such as eating and having sex, are associated with elevated dopamine levels
THE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 6 of 23 Handout 1 • Family Education GroupTRIGGERS AND CRAVINGS PRESENTATION NOTES continued Slide 13 Initially, People Take Drugs Hoping to Change Their Moods, Perceptions, or Emotional States . .
Translation— Hoping to Change Their BRAINS Slide 14 But Then . .
After People Use Drugs for a While, Why Can’t They Just Stop?THE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 7 of 23 Handout 1 • Family Education GroupTRIGGERS AND CRAVINGS PRESENTATION NOTES continued Slide 15 Because . .
Their Brains Have Been Rewired by Drug Use Slide 16 Most drugs of abuse, including cocaine, marijuana, heroin, alcohol, and nicotine, activate the reward system and cause neurons to release large amounts Prolonged Drug Use Changes of dopamine. Over time, drugs damage this part of the brain. As the Brain in Fundamental a result, things that used to make you feel good, like eating ice and Long-Lasting Ways. cream, skateboarding, or getting a hug, no longer produce the same positive feelings. The brain’s capacity to generate positive feelings has been impaired for a period of time
THE MATRIX MODEL, Revised & Expanded© Matrix Institute
Duplicating handouts for personal or group use is permitted. 8 of 23
_____Handout 8: Helping Checklist for Families (Advanced Stage of Recovery) Session 6: Living with an Addiction(discussion group) _____Handout 9: Living with an Addiction _____Handout 10: Medication-Assisted Treatment Presentation Notes u u u Family Education Group Handouts
for those used in the Family Education group sessions. Individual handouts are used for Family Education sessions because family members attend this group with clients and do not have the handouts from the.
Gives family members handout FE 6C—Family Members and Recovery Explains that the handout contains some concepts that are important for family members of a person in recovery to remember and that referring to it from time to time may be helpful Open Discussion (15 minutes)
When deciding who should be included in the Family Education group, programs should use a definition of “family” that accommodates important people in a particular client’s life. For example, a long-term romantic partner should be considered family whether the partner is married to the client or not.
Family Education Handouts Number Handout Title FE 1A A Definition of Addiction: American Society of Addiction Medicine FE 1B Thought Stopping FE 2 Fact Sheet: Alcohol FE 3A Guidelines for Graduate Panel Participants