Substance Use: Addiction Theories New Treatments and the Role of Doctoring in Society
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- Опубліковано 3 чер 2024
- 9 out of 10 people with substance abuse problems started using by age 18. What puts someone at risk for early onset drug or alcohol use? is is heritable? How are brain circuits involved? UCSF doctors answer these questions and discuss detection, diagnoses and treatment. [1/2018] [Show ID: 32939]
00:00 - Start
0:15 - Diana Coffa, MD
28:03 - Soraya Azari, MD
44:19 - Scott Steiger, MD
1:05:56 - Q & A
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I am currently in nursing school, have read several texts and listened to several lectures. This lecture, by far, is the most cohesive, understandable, intelligent and evidence based. Everyone keeps talking about providing non-judgmental treatment and care. This lecture provides mentoring and modeling for delivering unbiased, compassionate, professional interactions. I thank you.
Rotunno ADN good luck with the nursing, it takes a special person to do the job much 💖
I am working in a rehab for substance use disorder. Still searching to make recovery wonderful having experienced alcohol addiction myself. I am enlightened by this lecture
I agree
I'm a social work and chemical dependency counselor student. This lecture is an amazing resource! Thank you so much for sharing it!
Thanks for sharing. I live in Huntington WV, arguable the worst city in the US for substance use. A friend of mine who is a physician and I, along with some others have been discussing putting together a new, modern, progressive, and holistic center here (something that isn’t offered). I am responsible for the treatment program side and program and I am just searching the internet for anyone who would be open to helping us gather information to help support our program. You could imagine the attitude we have in Appalachia towards recovery. Again, thanks for posting and any help would be greatly appreciated.
Anyone else who sees this who is open to discussing this topic or related topics, we are open to talking with anyone or hearing from any POV.
Well wishes to all.
I live in Portsmouth, pretty much the same. Sounds interesting.
Good on you for willingness in wanting to implement an obviously much needed program in yr. community.
Many would balk at such an undertaking.
Having had experience in this area my experience showed me the importance of having input rather seeking input.from the community in which you intend to work.
Letting people know what yr. Facility is offering. What if any expectations do they have +ve & -ve. Do you intend to offer other programs you are offering. Such as Support groups for those participating beyond
hi i was wondering did you get your treatment program up & running? its been 2yrs now & i would've expected more help for the questions you asked. its great to hear of people taking the bull by the horns & saying enough is enough, we need to do something about this. there obviously arnt enough treatment options so every one helps.
@@jennzenn971 Hey, this was an unexpected but great reply. Unfortunately, the physician I was partnering w/ who would be starting prescriber and attending got cold feet somewhat. She had a great job running a division at her current location at VA Hospital and choose to stay instead of leaving practice, which I totally get too. After that. I had some bad relationships and situations involving legal matters Id rather not speak on and it was just kind of the icing on the cake. Afterwards. I've shifted focus more on maintaining my own mental/physical health and pursuing other loves of my life that I neglected for so long and still was even being sober for years and involved heavily in recovery community. Id def. be open to options in future but not trying to be the spearhead of these operations anymore.
I stopped a ravaging, disgusting, deceitful, hate-filled 14-year addiction to opiates. I was told I was expecting a son. No 12-step, no Therapies, no buprenorphine treatments. I'm not saying that is the norm but to imply that it is not possible is misleading. I am tired of living in a society where personal responsibility, will and determination are second class traits behind recommended years of Therapies. I've not had a relapse, drink or Taken give me directions in 9 years
They’re not second class traits but, often, they’re not enough. People were constantly telling me to use character traits to beat addiction, which I tried, yet felt like a failure again and again. Some of the reasons it didn’t work were that I had untreated Bioplar Disorder, and multiple nutritional deficiencies. Another reason is what drugs, themselves, do to the brain, largely shutting down certain areas, and creating multiple pathways only for their pursuit and use. If you were able to stop on your own, your brain was clearly less affected than some, as I’ve met people who don’t know who they are or what’s going on around them. Yes, I’ve “quit everything,” when I was expecting a child (and I gave myself a lot of moral credit) but my addiction was nothing at that point, compared with later on in my life. I had stayed off opiates for several years, each time I gave birth, but the problem came back again, manifold. Until my underlying disorder was treated, I didn’t have the ability to be rational and make good decisions, or any decisions of my own. I suffered from psychosis and delusions. Counselors and programs telling me it was my character flaws and weakness of character causing myself and my family to suffer destroyed all hope and self-esteem I had. Scientific demonstrations of addiction in the brain, like this one and especially Marc Lewis’s book about the Neurobiology of Addiction, restored my hope and self-esteem. The reason that the character-based Moral Model of Addiction is being challenged is that, far from being second class, it is the dominant theory, and treatment modality, in this country, and has done a great deal of damage to patients. I don’t think any counselor isn’t thrilled to see a patient high-functioning enough to use character traits to beat their addiction. However, it is past time the rest of us stop being treated like hopeless cases for having co-occurring disorders and brains that have been altered in ways that are typical manifestations of the disorder we seek treatment for. I agree that you, obviously, did not need treatment to quit, and that there are others who are similarly capable of using all their strength to quit on their own. If that was typical, though, treatment would cease to exist, which would be great! Unfortunately, it’s not that simple for a lot of people. I’m not downplaying what you did or saying it was easy, but there are cases that are a lot more complicated. No matter how smart or strong I am, I could not have done my own dual diagnosis and treatment. That is why I am studying to help others. Like the speaker said, we all have a lot to learn about the effects of addiction, and its effective treatment.
Substance use disorders????!!!!
A very strong genetic component.
Maybe your not an addict? Just saying like,ive definitely git the disease as I'm not wired up properly but I need to keep working on self,nowt short ov a miracle id say stopping like that,any addicts a miracle clean,all the best to you
You trade a bad addiction for a good addiction.
I am a CCAR Certified Recovery Coach, fantastic lecture. Thank you.
Cool dude 😎 👌 👍
In college, the professor had us read a book with many a passage about drug users and their experiences, for example: Maybe if I had not had such a good experience with alcohol the first time I wouldn't have such a strong affinity towards rum. I grew up with alot of people who I admired and their drinking never affected their behavior and since I thought _they_ were cool I associated drinking with being cool. If instead of feeling warm and loved after my first drink I had in reality witnessed a severe and fatal motorcycle collision, car accident or volatile behavior I'd probably be less into consuming what I view as one the most socially acceptable drugs, right up there next to caffeine from coffee and nicotine from cigarettes (one of my favorite and go to stimant comibinations at one time)
Great lecture thanks for presenting this.
This was awesome to watch. Ty
Great talk. Thank you!
I was so happy to see Scott😉☺
Thank you!
Thank you so much for this extremely important lecture. I am a pediatrician, and this is a fascinating subject we need to pay more attention to. Thank you Dr Coffa and Dr Azari and Dr Steiger.
Um ah
@@DrChristpherDoyle omg it's driving me crazy
Adult Role Model!¡???
Ms.Coffa very interesting!?!!!
Mice, Human addiction relocation, rehabilitation is A.A. description of traveling to run away from Addiction...
This was very informative. My only criticism is the lack of emphasis placed on other forms of therapy like CBT for drugs as well as alcohol. It was glossed over, when there is a huge body of research that has found CBT to be highly effective to address SUD. CBT on an app should ONLY be a follow-up for homework, practice or in after-care for maintenance as advised by their therapist-never a stand alone. Aside from genetics and risk factors, there is a key reason people pick up-that is what must be dealt with. CBT can work in concert with pharmacological forms of treatment. We will not make a dent in providing effective treatment if clinical social workers and medical doctors do not respect or value eachother's work.
It’s discusting that there’s not more funding for alcohol abuse wen them the greedy alcohol industry and treasury make billions of pounds a year and not one word spoke about it in school how addictive it is
CBT like it’s predecessor RET are overrated.
@@brunomallows552 what?????
Blaming my addiction on family wasn't helpful. Creating victims is how we have complicated addiction. Non of this is related to recovery. This is interesting stuff but can make it very difficult for addicts to take responsibility for our recovery.
Really important, necessary information in this session. I hate to be the one to mention it- I've got impulse control issues/tics just as pronounced as the next guy- but the first doctors, "uhh*smack*uhhmmm*smack*" is almost painfully distracting >_
100%. This is why I came to the comments.
Agreed!! She has a great presentation; but, the "umm uhh" bothered me tremendously! I could hardly finish her part of the lecture.
Very good presentation but please note that Registered Nurses don't only watch the patient take the medicine. We assess the patient's physical and mental status and identify when withdrawal symptoms are present or imminent . We are the ones who inform the doctors of the presenting problems and then the doctor further assess, diagnose and prescribe if the nurse is not a Nurse Practitioner.
No,this cannot be true!?!
A Drunk in denial!!!!!!!
Stealing is not a good way to maintain.
12 years old is too young to be at an unsupervised party where there is alcohol. Personally, I would not allow my son or daughter to attend a party if I knew alcohol was available and there were irresponsible adults there. I'd rather have a few friends gather at my home so I can be present.
Basic info by Dr. Diana, but I will give her a higher compliment for her speaking, presentation skills. I listen to a lot of speakers, she has the skills. Great to not hear any "ums" unlike the next speaker.
It was hard to follow her due to all her ” ummms. “
Sure, those mmmss!! Interfering with presentation. Annoying
I'm here with a deck full of ACEs, drinking and smoking while watching.
Im an addict.. and a family member of an addict. I am a pro criminal justice, a law enforcement supporter who also happens to be a convicted felon for drug related activity and this is a crock of shit and has caused more damage to addicts.
How so? Could you outline your argument?
Judging by you’re sub feed you’re basically a right wing schizo
Um, uh.
Great video, although there is not such a thing Substance Use Disorder, or Addiction. In this video there are mentioned many factors for substance use and also many ways to quit substance use. i used to be heavy alcohol drinker, but when i came to San Francisco i quit drinking without any effort. Environment plays a very important role. Support from friends and family it will also help big time, but usually family members start the fights, pretending they care, it is a matter of power and control.
According to the DSM 5, Substance Use Disorder is very real. That title is used to describe behaviors characterized by 12 criteria detailed in the DSM 5. What you are discussing is a form of treatment or a motivating factor in your environment that helped redirect your focus and aided you in making choices that supported abstinence over picking up. If you recall the very beginning of this session-the first speaker discusses a study using rats from the 70's. She did not share the entire finding. It found that when a person is apart of a community and feels that sense of belonging that alone can support abstinence, whereas being isolated without a community could increase the use of substances. Treatment can look different for everyone. It does not mean SUD or addiction is not real. It is.
"there is no such thing as addiction" is the earth flat too?
In 10 years SUD would sound the same as how dependent and abuse sound. Of course we will find new words, for however bad reality is, it shouldn't sound bad.
As someone who went through these things I strongly disagree. Once we introduce new phrases they'll just gain the same issues as we repeatedly use them. The phrase themselves isn't the issue, they don't even matter. How does changing what you call it actually help me or anyone else?
I don't disagree with you at all. I intended some sarcasm which didn't got through. I don't care about words as much as I care about attitudes. Thinking changing words is revolutionary is meaningless. However this process has come to stay. I would rather work towards changing attitudes and stigma in general public than linguistic advocacy. Thanks for your reply.
Hello! I found your discussion interesting, Dheeraj and Alec. Can we hope that linguistic advocacy could be a means to change attitudes and stigma? That's what I understood here; changing the words will change the way health workers and the general public view SUDs and those suffering from these. Our words are how we articulate our thoughts right? So, if we choose to have a language that is not discriminating, we can change our thoughts and thus attitudes too?
I disagree with the premise. It smears healthcare workers who care for those with problems related to substances to harbour 'wrong' attitudes which will change with words, when people who use politically correct language could well have very bad attitudes towards those who use substances. I really wish what you wish, that people have good attitude towards those who use substances. However view is linguistic advocacy is simplistic.
what was the 70s mice study?
en.wikipedia.org/wiki/Rat_Park
Rat Park yes, same principal existed when the Vietnam veterans came home from war with heroin habits
Yes,low risks, not so!!!!
@@caseybald1798 the greatest!!!!
Intervention is imperative!??!!
A for effort...
However, As a SUD-AOD counselor... This is, in 2022, speaks volume that drugs are Still Winning. I question your data's accuracy.
Would have been impactful had you considered having a guest speaker in recovery and shared their journey.
People are people...Not #'s and stats and graphics.
This is a large obstacle associated with the lack of confidence and trust for people with said challenges to feel safe with " Clinicians...Doctors...Therapist..."
All that white board does is dehumanize...humans.
What about the population without insurance?
What about the population whom are being violated by "providers?"
This field disturbingly manipulates and violates, for billing dollars and other status accolades at the expense of patients/consumers/clients from 0.5 to 4.0 LOC Tx.
Broken systems gut the motivation of those in the struggle for survival.
MEDICAL recipients are the most underserved and abused population in this space.
Are you serious ?!
What about CBT... Client centered treatment?
So many modalities missed out on.
Holistically, Your panel tipped on this ideology...yet, it's so imperative that, yes, the entire person MUST be treated.
Thank you
Lots of ums but I got ya
Lol. I was wondering if I was the only one that noticed the second speaker.
I am working on a documentary to end the stigma of substance abuse, specifically about how it affects California residents. We are looking for brave individuals to share their stories. Check out our page for more details.
Blue skies production. Where would one go to discuss????
Stigma.
Umm
Have a shot each time the second speaker says umm uhh
You'll be dead in 5 minutes
I really liked the video but I agreed that the second speaker is so distracting with her umm ammm. She uses it so many times, it ready disrupted my learning. She looks and sound very smart but she has to work on her presentation skills. It's so disruptive the hum and amm, ahhh
@Matteo Rivera
Lol! Good to keep ur sense of humor. Thanks for that healthful reminder!
The problem with harm reduction is that the user is still using. It is the same with giving methadone or suboxone. The doctor here is under the belief that giving a small amount of drugs or alcohol is enough to keep the user satisfied. Addicts and alcoholics are never satisfied. This is the problem. So people use ON TOP of taking methadone or suboxone.
Yes SOME addicts use in top of these medications....a hell of a lot of people also drink alcohol or use on top of prescription medications because the lable says "alcohol may intensify effect"
Then go on and drive or some other reckless behavior
The vast majority of addicts on methadone or soboxone become contributing members of society
(Not stealing or using needles or manipulating others to get their daily fix)
So would you rather have millions of these people kicked off these medications returning to crime and high risk behaviors?
I suppose we could round up all addicts and kill them
Good luck convincing people they need to murder their brother, sister, mother, father, uncle etc....
Its called "harm reduction" not "harm removal"
Its not perfect
@@martinnibataan7046 Yeah no. People on methadone or subs are still trapped in their addiction. Yes the risk for overdose is diminished, but the person is still medicating themselves, and methadone and subs are way harder to get sober from because the detox is tougher. Not to mention that suboxone stays in your system for up to 6 months. All you are doing is just changing the drug dealer. The medical community has no respect for the recovery community or for addicts, and would rather just "kick the can" down the road rather than actually address the problem.
If you want to use suboxone to "wean" someone off heroin that is one thing, but I'm telling you as someone who has suffered from an addiction and works in substance abuse that it rarely happens.
theseancorcoran You hit the nail on the head! People with this Disorder don’t want to be sick but they still what to be high! And unfortunately this harm reduction phenomenon keep addicts addicted and line the pockets of harm reduction facilities with money! Using drugs is dangerous not just for the user! To perpetuate that with helping them to use is ridiculous to me! Why not buy the drugs for them, let them live in the the facility! Oh, but if you did that you can’t make money! And even if this all worked out, chances are it wouldn’t be for Black people, especially the poor ones! We’re only having this conversation because by in large White peoples are dying from overdosing.
Harm reduction is a model...meaning it is an option that has been tested and seems effective in preventing overdoses and eventual abstinence. Sometimes this works best, and given the positive overall economic impact to state sponsored healthcare, it may become even wider used. If it works, it works. Dont criticize it.
Good information, if you can umm ahh umm ahh umm bare all the ahh, umm's an umm ahh's.
I could hardly bear them!!!
Um Aw um Aw um This is hard for me to even listen to
I just couldn't get all the way though the presentation, if I were in attendance, I would have left. WAYYYY too many "ummmm, ahhh, ummmm (smack the lips) ummmmm, uhhhh, ummmm, mmmmm uhhhhhh (smack the lips) ummmm, mmmm. uhhhhhhh, ummmmm..... Jesus Christ lady, take a basic public speaking course before you give another presentation. FFS. totally takes away from the content presented.
Excellent talk. Dr Azari really needs to stop with the filler language (uuum ahhh) and lip smacking. I couldn't glean much from her talk with that huge distraction.
So Janes is mad at her father for leaving? Her mom set boundaries but the bad left? This is what wrong with universities and therapy in general it’s gender bias
Um um ah um
Yum. Ah. Over and over is so distracting. I really wanted to stay for the whole lecture but you lost me
Umm errr ummm errrr - if you are hesitating keep quiet instead of umming and erring
Great lecture I just can't do the emm urrr
Azari, please take some speaking, training classes. I couldn't stand listening to you. Um, um, um...
When did Wikipedia start giving out M.Ds? 😆