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Slide 1
Jasmin Kaur Addiction Therapy-2014 Chicago, USA August 4 - 6,
2014
Slide 2
Helping Clinicians Connect Understanding Addiction from the
Perspective of a Drug Abuser Jasmin Kaur, Psy. D.
Slide 3
Small country, 716.1 Sq Km Resident population of 3.8 million
(2013) Geographical location Strict legal restrictions on drugs
Recidivism rates of drug offenders ~ 27-31% Background: Singapore
The views expressed in this presentation are the authors only and
do not necessarily represent any official view of the Singapore
Prison Service or the Ministry of Home Affairs, Singapore.3
Slide 4
Qualitative study ~ 30 drug abusers Drug Initiation &
Maintenance Motives Social Factors ~ Drug Cues Understanding Drug
Abuse The views expressed in this presentation are the authors only
and do not necessarily represent any official view of the Singapore
Prison Service or the Ministry of Home Affairs, Singapore.4
Slide 5
Motivation Model of Behaviour Be Healthy Setting Goals Exercise
twice a week Finding Appropriate Means Overcoming sleep and waking
up Ignoring Distractions & Negotiating Conflict Going for a run
in the morning Taking Action Kpetz, Lejuez, Wiers, Kruglanski, 2013
The views expressed in this presentation are the authors only and
do not necessarily represent any official view of the Singapore
Prison Service or the Ministry of Home Affairs, Singapore.5
Slide 6
Motivation Model of Behaviour : Drug Initiation Seeking Thrill
or Belonging Setting Goals Drug Experimentation Joining a sports
activity Finding Appropriate Means Potential Harm or Legal
Consequences Overcoming fear of being judged Ignoring Distractions
& Negotiating Conflict Consume Drugs Sign up for taekwondo
class Taking Action The views expressed in this presentation are
the authors only and do not necessarily represent any official view
of the Singapore Prison Service or the Ministry of Home Affairs,
Singapore.6
Slide 7
Motivation Model of Behaviour : Drug Initiation Satisfy
Curiosity or Belonging Setting Goals Drug Experimentation Finding
Appropriate Means Potential Harm or Legal Consequences Ignoring
Distractions & Negotiating Conflict Consume Drugs Taking Action
The views expressed in this presentation are the authors only and
do not necessarily represent any official view of the Singapore
Prison Service or the Ministry of Home Affairs, Singapore.7
Slide 8
Motivation Model of Behaviour : Drug Initiation Satisfy
Curiosity Setting Goals All my friends were doing it, so I just
joined in the crowd for the sake of the fun. I saw my childhood
friends taking Marijuana and getting high.. I was curious, so I did
not think to say no. Finding Appropriate Means Because around 15 to
16 years old, I left school and left home; I was so free. So I have
nothing to do I try to smoke Cannabis had no addiction, makes you
chill, relax. Ignoring Distractions & Negotiating Conflict
Friends were smoking Cannabis when hanging out, I nothing to do,
was bored, so just try. Heroin I just take for excitement. Taking
Action The views expressed in this presentation are the authors
only and do not necessarily represent any official view of the
Singapore Prison Service or the Ministry of Home Affairs,
Singapore.8
Slide 9
Motivation Model of Behaviour : Drug Maintenance Drug
Consumption Setting Goals Oral / Intravenous Abuse Finding
Appropriate Means Potential Harm or Legal Consequences Ignoring
Distractions & Negotiating Conflict Find drugs at all costs
Taking Action The views expressed in this presentation are the
authors only and do not necessarily represent any official view of
the Singapore Prison Service or the Ministry of Home Affairs,
Singapore.9
Slide 10
Motivation Model of Behaviour : Drug Maintenance You looked
worried, you looked sad. Chase the dragon and you will never
forget. All your problems fly away after you smoke. Setting Goals
Normally when we start I start a lot with soft drug meaning drugs
that prevent you from getting caught like taking tablets, injecting
tablets like Dormicum, Subutex. But after a while you start to jab
and eat, then from there not shiok (good feeling) ready. Finding
Appropriate Means Actually I consider stopping the drugs, but I
dont know why [I still take drugs]; people say only until you kena
catch (get arrested) then you will know when to stop, if not you
wont really know when to stop. It is not really a habit, it is when
I want to take it then I take it. Ignoring Distractions &
Negotiating Conflict Sell pirated CDs to finance (my drug habit).
Everyday work 2 hours, can buy heroin for 1 day. Whatever comes I
will do. (Also some drug trafficking) take big amounts of drugs and
resell to other people. Quick and fast money, work less hours.
Taking Action The views expressed in this presentation are the
authors only and do not necessarily represent any official view of
the Singapore Prison Service or the Ministry of Home Affairs,
Singapore.10
Slide 11
Motivations for Continued Drug Use Leventhal & Schmitz,
2006; Oei & Morawska, 2004 Negative Expectancies Removal of
withdrawal symptoms Positive Expectancies Anticipation of euphoria
The views expressed in this presentation are the authors only and
do not necessarily represent any official view of the Singapore
Prison Service or the Ministry of Home Affairs, Singapore.11
Slide 12
Motivations for Continued Drug Use Negative Expectancies
Continued to smoke (heroin) because cannot take the withdrawal body
aches, vomiting, diarrhoea, running nose). Take not because of the
craving but because of withdrawal (from heroin). Another reason I
go back to Heroin is because of the sakit (pain/withdrawals). If I
didnt get this thing I will have the pain. Positive Expectancies
Yes. I like the euphoria effect. [It's] like joy like that, because
we all drug addicts have the feeling and the mind that you cannot
think of anything [other than drugs] if I dont do drug I dont know
what to do. And if got money also doesnt know what to do with the
money, [so] then have money then just take drug. If no drug, the
emptiness cannot match (nothing can match the effects given by
drugs). I use Ecstasy twice a week because I just want to, its just
for a moment of euphoria, like very happy. The views expressed in
this presentation are the authors only and do not necessarily
represent any official view of the Singapore Prison Service or the
Ministry of Home Affairs, Singapore.12
Slide 13
Drug Cues Drugs Environ ment Affect Drug stimuli The views
expressed in this presentation are the authors only and do not
necessarily represent any official view of the Singapore Prison
Service or the Ministry of Home Affairs, Singapore.13
Slide 14
Drug Cues Drugs Environ ment Affect Drug stimuli Feel craving
when see the drugs and see people taking. Because we ever take
before so we know the high, its better than anything. Nothing beats
the feeling. When walking along the street going to urine
supervision, meet ex-drug inmates again, talk about our past drug
experiences, reminds me of taking drugs When I see aluminium foil
or when I walk pass a block where last time on top got people
selling, though they not necessarily have to be there anymore.
Aluminium foil, whether big or small, will induce cravings. The
views expressed in this presentation are the authors only and do
not necessarily represent any official view of the Singapore Prison
Service or the Ministry of Home Affairs, Singapore.14 I see heroin
and my friends taking then I take because of the trigger. When get
too emotional whether positive or negative feelings then will think
about drugs. Automatic thinking, link emotions to drugs, memories
of taking drugs come back.
Slide 15
Extrinsic vs. Intrinsic Self-regulation Essential
Resource-intensive Easily drained when cognitively overloaded
Regulation The views expressed in this presentation are the authors
only and do not necessarily represent any official view of the
Singapore Prison Service or the Ministry of Home Affairs,
Singapore.15
Slide 16
No need for liking when abuser wants a drug Dislike of negative
consequences but unable to stop drug use Wanting vs. Liking I have
lost my job, friends, girlfriend and freedom. After first DRC
already like this. I continue because I really cannot control. It
is very hard to say if it is worth it because when you take drugs,
you will think that this stuff is stupid but when you are taking
drugs, you wont feel that it is stupid. The views expressed in this
presentation are the authors only and do not necessarily represent
any official view of the Singapore Prison Service or the Ministry
of Home Affairs, Singapore.16
Slide 17
Remove Drug Cues Seek Alternative Actions Reduce Cognitive Load
What has helped? The views expressed in this presentation are the
authors only and do not necessarily represent any official view of
the Singapore Prison Service or the Ministry of Home Affairs,
Singapore.17
Slide 18
Effective coping & self-regulation strategies For new
abusers - addressing underlying motivation of drug use and find
alternatives to satisfy these motivations For long-term abusers,
seeking alternatives to drug cue activations How Clinicians Can
Connect? The views expressed in this presentation are the authors
only and do not necessarily represent any official view of the
Singapore Prison Service or the Ministry of Home Affairs,
Singapore.18
Slide 19
Research Team at Singapore Prison Service Natasha Lim Yan Jia
Yin The views expressed in this presentation are the authors only
and do not necessarily represent any official view of the Singapore
Prison Service or the Ministry of Home Affairs, Singapore.19
Acknowledgements
Slide 20
Bandura, A. (1999). Kpetz, C., Lejuez, C., Wiers, R. &
Kruglanski, A. (2013) Motivation and Self-Regulation in Addiction:
A Call for Convergence. Perspectives on Psychological Science,
8(3). Leventhal, A. M., & Schmitz, J. M. (2006). The Role of
Drug Use Outcome Expectancies in Substance Abuse Risk: An
Interactional-Transformational Model. Addictive Behaviors, 31,
2038-2062. Oei, T. P., & Morawska, A. (2004). A Cognitive Model
of Binge Drinking: The Influence of Alcohol Expectancies and
Drinking Refusal Self-Efficacy. Addictive Behaviors, 29(1),
159-179. Tiffany, S. T. (1999). Cognitive concepts of craving.
Alcohol Research & Health, 23(3), 215-224. Tiffany, S. T. and
Carter, B. L. (1998). Is craving the source of compulsive drug use?
Journal of Psychopharmacology, 12(1), 23-30.
doi:10.1177/026988119801200104 Vaillant, (1995) Weinstein, A. and
Cox, WM. (2006) Cognitive processing of drug-related stimuli: The
role of memory and attention. Journal of Psychopharmacology, 20,
850-859. The views expressed in this presentation are the authors
only and do not necessarily represent any official view of the
Singapore Prison Service or the Ministry of Home Affairs,
Singapore.20
Slide 21
Thank You The views expressed in this presentation are the
authors only and do not necessarily represent any official view of
the Singapore Prison Service or the Ministry of Home Affairs,
Singapore.21
Slide 22
Addiction Therapy 2015 Website:
addictiontherapy.conferenceseries.com Meet the eminent gathering
once again at Addiction Therapy-2015 Florida, USA August 3 - 5,
2015