Addictions in the Media

http://www.addictiontreatmentmagazine.com/addiction
/internet-addiction/social-media-site-addiction-and-borderline-
personality-disorder/

         Addiction can be seen throughout the media, whether it is on TV, in music, in movies, or in the public lives of celebrities. Regardless of which method, it is influencing adolescents. According to a recent study, “21 percent of elementary school children and 51 percent of 12^th graders have tried alcohol” (“Media and adolescent substance abuse,” 2011). Also, of today’s smokers, “90 percent began by age 19” (2011). These statistics help prove that exposure to drugs, at a developing age, increases the percent of those who use drugs ("Why Kids Use Drugs," 2013).

         Influential factors for adolescents includes parents, peers, and media. One study showed that these individuals spend "8.6 hours a day engaged with the media and only 1.2 hours a day with non-electronic media" (“Media and adolescent substance abuse,” 2011). This shows that individuals are watching more TV than reading books, and that they are being exposed to more drugs much more frequently than in the past. To help support that, the study also showed the quantity of movies that adolescents are watching contain, “93 percent alcohol use, and on television, alcohol is 77 percent of the shows” (2011), and that “each increase of 1 hour per day of television increases risk of starting to drink alcohol during the next 18 months by 9 percent” (2011). These facts are significant and scary for the population of adolescents and parents raising them.

http://www.smh.com.au/technology/technology-news/screenaddicted-
children-may-have-newest-mental-illness-20120929-26s7q.html

         This increased incidence is due to the fact that adolescents have not completely formed their own identities, so they are experimenting with what they see on TV. Therefore, this exposure translates into initiation of use of alcohol or drugs. A strong emotional response can bypass logical thinking, so even though the individuals know that they should not be smoking because it causes harm to the body, they do it anyway (“Media and adolescent substance abuse,” 2011) & (“Kids & the Media” 2013).

         Here are a few examples of songs that use alcohol and drugs. After listening to the songs and reading the lyrics it is not hard to see why adolescents are having a difficult time separating wrong from right with regards to drug use (LeHericy, Z. & Liberman, M., 2009).

“Blame it on the Alcohol” by Jamie Foxx

Here is another example of a song where Afroman is singing about getting high, and even though he is singing about things going badly, there is still laughing and joking in the background. Also, the tune is light and catchy so people want to listen to it.

“I Love College” by Asher Roth

“Get my Drink on” by Toby Keith

“A Baltimore Love Thing” by 50 Cent

Sources:

“Media and adolescent substance abuse” (2011). Johns Hopkins Children’s Center. Received April 18, 2013, from http://www.hopkinschildrens.org/media-and-adolescent-substance-abuse.aspx

“Kids & the Media” (2013). American Psychological Association. Received April 18, 2013, from http://actagainstviolence.apa.org/mediaviolence/index.html

LeHericy, Z. & Liberman, M. "Sex and Drugs: How the Media Influences Today's Youth" (2009). The Maverick. Received April 18, 2013, from http://hs.riverdale.k12.or.us/maverick/?read=775

"Why Kids Use Drugs" (2013). Focus on the Family.  Received April 18, 2013, from http://www.focusonthefamily.com/parenting/parenting_challenges/kids-and-substance-abuse/why-kids-use-drugs.aspx

Videos:

http://www.youtube.com/watch?v=lrDrCF-T88g

http://www.youtube.com/watch?v=UR1r6NCeoaM

http://www.youtube.com/watch?v=SAAyNyywhHc

http://www.youtube.com/watch?v=Yz49-uKK_S4

http://www.youtube.com/watch?v=5zAGHS_l2DU

Pictures:

http://www.addictiontreatmentmagazine.com/addiction/internet-addiction/social-media-site-addiction-and-borderline-personality-disorder/

http://www.smh.com.au/technology/technology-news/screenaddicted-children-may-have-newest-mental-illness-20120929-26s7q.html

Habit Summary

How did you select the behavior you were willing to change?

         It was an easy decision for me to select the behavior I was willing to change. Without a doubt, biting my nails was the habit that I needed to break, whether it was going to be easy or not. I was aware that it was not only physically unattractive but also detrimental to my health and painful. In addiction, this summer I start my level 2 fieldwork as an occupational therapy student, and to have nails that look disgusting is very unprofessional in the health field. No one will want my help (or for me to touch them) if they see that my fingers are bloody and always in my mouth. It is unsanitary for clients, co-workers, and myself.

How easy or difficult was it to abstain from engaging in that behavior?

         At first abstaining from engaging in nail biting was very challenging. Biting my nails was a habit that was second nature for me. I have bit my nails since as long as I can remember so quitting was that much more difficult. It was extremely difficult because most of the time I did not even realize that I was doing it. In the beginning stages, I thought how could I stop doing something that I do not realize that I am doing? Luckily I became more aware of my behaviors and used my friends as supports to help me kick the habit.

Did you have any help/support? If so, from who? Did that make a difference in your success?

         I had help and support throughout the process, and it is a good thing because I do not know that I would have been as successful if they were not there for me. Specifically, my roommates were aware of the experiment and helped me stopped biting my nails. Every time they would see me with my hands in my mouth I would get a verbal warning of some kind, and if that did not work then they would physically push my arm down to get my hands out of my mouth. During this time, I was definitely cranky, and I’m sure they were not happy with me. However, they really helped me, and now I can thank them. I really owe a great deal of my success to them and I am very thankful that I had them. I am lucky that they did not give up on me, even when I was irritable and told them to leave me alone. The 3 of them kept doing what I asked them to do in the very beginning, and now my nails are painted, long, and look nice.

What were some things you learned about yourself through this assignment?

         I learned new things about myself through this assignment. First, when I am stressed, that is when I have to be aware to keep my hands away from my face. Stress has always triggered my nail biting, as it is a nervous habit; however part of overcoming that is my will power, that I know I have now after completing this experiment. I also know how great it feels after fighting the urge and being successful. Other triggers I noticed were boredom and seeing someone else bit their nails. Interestingly enough, seeing someone else bit their nails was a trigger for me in the beginning, but now I see someone and it disgusts me, motivating me to keep my hands out of my mouth even more. This is so interesting and proves to me that I have really changed my mind-set mentally and that I kicked the habit. Lastly, because I am an organizer and a “neat-freak” I like things looking nice so that pushed me to not mess up my nails. Knowing that they were not the same length or looked messy ended up driving me crazy so using my other traits to stop this habit really helped me as well.

How does your experience connect to information you have learned through assigned readings and in-class discussions?

         Based on the knowledge I gained during this experience, I can understand how difficult it would be for someone to fight an addiction. I had great difficulty trying to change my habit because it was psychological and comfortable, which is something that people with addictions can relate to. For example, someone who is addicted to smoking or drinking finds that comforting. Also, most likely they have done it a long period of time, which makes it more difficult to stop because it is a way of life. It not hard to see why changing an individual’s behaviors and actions would be a life struggle.

         There are many different supports and approaches that would be beneficial to someone trying to change a behavior. For starters, changing the environment is a great first step. This includes where they are going, whom they are with, and what they are doing. Changing these factors, although challenging, keeps the individual at a safe distance away from what their addiction. According to class discussions and readings in the textbook, this “out of sight, out of mind” technique is very helpful. Also, according to our textbook there are other approaches that are strength based, such as solution-focused therapy and narrative therapy. These approaches really focus on the positives of life and stray away toward the negatives.

         Lastly, a huge support in trying to over come an addiction is the actual people who are supporting you, whether that is family, friends, sponsors, or individuals who are also trying to over come an addiction. These people are there to help you throughout the journey and are a driving force. I know with my nail biting, I would not have been able to stop the habit if it were not for my friends and family.

         I believe that habits can be broken, as people change throughout their lives. I strongly believe that I have stopped biting my nails for the rest of my life. Now, it is very possible that I could slip up from time to time if a nail breaks, however I know I will not find my self in the same position I was once in. I truly believe that I will never have all my nails so short that they are bleeding and constantly in my mouth. I think this is similar for addictions in that the more you want to fight the addition, the better your chances are for conquering it and being successful. As we saw in class with the guest speaker, she was drug free, but she knows herself well enough that her “addictive personality” can get her hooked to almost anything. The fact that she knows this about her self is a great step in fighting any addiction that could come along. I think that addictions can be controlled, however, there might always be that underlying message of “what if,” which is something that is located deep in the brain. Both guest speakers appeared to be leaning toward the way of addiction being a disease and not a choice, which makes me think that addictions cannot be cured; however they can be controlled. Through the readings, class discussions, and habit experiment, I feel like I have a great appreciation and understanding for individuals with addictions and that I will definitely be able to take all that I have learned with me and apply it to my future career.

Interview

What type of agency did you select and with whom did you speak?

     I had the opportunity to speak with Steve, a Registered Nurse who works in the mental health unit of Lancaster General Health (inpatient hospital).

What types of services are provided to individuals who may be struggling with an addiction?

     Services include medications, support groups, and therapies. Since this is an inpatient hospital, nurses provide all medications to their patients, which is related to their condition and addiction symptoms. Some individuals that are addicted to nicotine receive gum, patches, and/or an inhaler. The inhaler provides them with the enough nicotine to satisfy the cigarette craving. It also is comforting because you hold it like a cigarette and it has a similar appearance. There are specific AA meetings held at night for those individuals who wish to attend. Therapy sessions are also offered by social workers, psych techs, and nurses to work on recovering to eventually be discharged out of the facility.

What is the agency’s framework for providing services?   

     They provide a 12-step AA program, but the main focus is recovery based. They focus on intervention, prevention, education, assessment, and referral. The groups throughout the day usually focus on two or three of the topics previously mentioned. The first step is to stop using the drug. Some individuals need medicines to manage their withdrawal. Then, they focus on staying drug-free, and this is aided with therapy and group counseling along with other medicines if needed. The next step includes changing his/her life so that they can recover. This involves changing their environment, who they are with, and what they are doing. (They do provide direct services such as counseling and medication because they are an inpatient hospital, which indicates 24-hour care.)

How many clients does the agency serve on an annual basis?

     Steve was unsure of the number annually; however the agency serves about 32 individuals a day with a length of stay being about one week. Some individuals are there for a shorter period of time, others are there for a much longer time period; it depends on the person, illness, and determination.

What are the legal and ethical guidelines that impact the work they do with clients struggling with addiction?

     Legal guidelines include if they need isolation or restraints. If they do require any form of isolation or restraints then there is legal paper work that needs to be filled out. The paperwork is seen in court by a judge and will indicate a mandatory longer stay in the hospital. Ethically, some of the individuals are pending criminal charges on a day to day basis and helping professionals should not judge them and try their best to help them. For example, one man is a registered sex offender, drug user, and just recently had a failed suicide attempt. Regardless of his past, as a helping professional, they are still required to give them the best quality of care. 

How long have you worked at Lancaster General?

     Steve said that this was his first job out of college (Penn State), and he liked it so much that he has been here ever since (32 years).

Do most of your patients have Co-occuring conditions?

     Steve said that the primary reason the individuals get admitted to the hospital is because of a mental health reason; however, the majority of the individuals have an addiction to drugs and/or alcohol.

How do the majority of your patients come in?

     The majority of the patients come through the emergency room, whether they enroll themselves or are brought by a family member or police.

Where do the majority of your patients get discharged?

     The majority of the patients get discharged back to his/her home.

How does your experience connect to information you have learned through assigned readings and in-class discussions?

     My experience connected directly to in-class discussions and assigned readings. We read about treating the individual as well as the family and therapy (at the hospital) addresses both, as they are a big part of the recovery process. Also, as we discussed in class, co-occuring disorders are difficult to helping professionals. This was a common theme at the hospital as well. Steve mentioned that differentiating between signs and symptoms of the mental illness or the addiction are difficult at times, and that majority of the people do have both an addiction and a mental condition. Steve also mentioned that many of the therapies are based around coping and managing triggers and cravings, which is something we spoke in class about. He said that because we are discharging these individuals, it is important to teach them life skills that will help them stay healthy. (He used the metaphor, of if you give a boy a fish he will eat for a day, but teaching the boy to fish will allow him to feed himself for life.)

Journal Article Response: Racial, Ethnic, and Cultural Issues

 Article Summary:

            The article used national data to look at racial/ethical disparities in smoking behaviors, cessation, and factors related to cessation related to various groups. Adults ages 20-64 years old were included in the data from the 2003 Tobacco Use Supplement to the Current Population Survey. It looked at non-Hispanic Whites, African Americans, Asian Americans/Pacific Islanders, and Hispanics/Latinos (Trinidad, Perez-Stable, White, Emery, & Messer, 2011).
            Results from the study showed that significantly fewer African Americans reported quitting smoking after long-term use; ethnic minorities were more likely to be light smokers. Racial/ethnic minorities were not less likely to receive advice from health professionals to quit smoking, but were less likely to use nicotine replacement therapy. The idea of focusing on better understanding the cessation needs may benefit all the groups (2011).

Thoughts and Connections:

            According to the textbook, racial issues are a sensitive topic because there is a large concern about stereotyping. The practice of lumping people together by an obvious external trait such as race or ethnic practices is open to criticism because it does not take into consideration other important factors. To avoid stereotyping, certain factors other than race must be taken into consideration. This includes individual experience of oppression and discrimination, immigration status, degree of acculturation, language and communication skills and patterns, education and socioeconomic status, religion, age, gender, and family structure.

            Our textbook focuses in on different races and the statistics worldwide. It also is important to take into consideration these individuals’ ethnic values, which will help lead people to the recovery process. Developing cultural competence includes learning about different cultures, and the better one can understand the issues, the better the treatment can be provided, which was a point that the article I read brought up. In order to better understand certain needs of different groups, individuals need to have a better understanding of the culture and race if that is what is important to them.

Article Reference:

Trinidad, D. R., Pérez-Stable, E. J., White, M. M., Emery, S. L., & Messer, K. (2011). A nationwide analysis of US racial/ethnic disparities in smoking behaviors, smoking cessation, and cessation-related factors. American Journal Of Public Health, 101(4), 699-706.

Journal Article Response: Family Risks and Resiliencies

 Article Summary:

            Addictions are a societal problem that is a growing concern and responsible for destroying families and communities. Research has shown that there is a strong correlation between disrupted family relationships and alcohol and drug addiction. This article includes interviews that were taken with 12 individuals who live and lived in the Higher Ground Alcohol and Drug Rehabilitation Trust. Results showed that the majority of the participants had experienced painful and traumatic childhoods in their families, which contributed to their addiction behavior and felt affected their current families. All participants and their families had suffered from different forms of family disruption such as loss of custody, marital breakdown, abuse, depression, and loss of employment. Other participants who were addicted and committed drug-related crimes experienced issues that also affected their relationships with their families (Schäfer, 2011).

            Four main themes were created after the interviews; however the most salient finding was that all participants felt they had not been able to develop functional relationships with their family. Substance use and dysfunctional family relationships yielded a strong connected according to the data. Overall, this demonstrates how addictions affect not only the individual but also the entire family (Schäfer, 2011).

Thoughts and Connections:

            According to our textbook, addiction often is an illness that affects the entire family, not just the individual. This is not hard to believe considering most people in the family care about one another. Frequently the upset is so intense that the family can barely function at all, and children growing up in these families cannot receive proper nurturing and care that they need. Due to these needs not being met, this addiction process commonly spreads through generations. This connects with the article I read because an issue they spoke about was not being able to develop functional relationships with their family (as a child) in the past and now they cannot form those relationships as an older person with their own family (as a parent) (Schäfer, 2011).

            When addiction is involved, the focus tends to lie on just that and not on the things and people who matter most. Not only does the person with the addiction have pain and complications, but also so does the rest of the family. Their problems revolve around how to deal with this person and their own strong feelings of upset. Addictions are also a source of major stress (emotional or financial) that spreads across and within the family system and affects the family dynamic and interactions with other systems in the community.

Article Reference:

Schäfer, G. (2011). Family functioning in families with alcohol and other drug addiction. Social Policy Journal Of New Zealand, (37), 135-151.     

In the Movies

Thirteen

http://upload.wikimedia.org/wikipedia
/en/d/dd/Thirteen2003Poster.jpg

Directed by: Catherine Hardwicke

Why I chose the movie:

            The movie I chose to watch for this assignment is Thirteen. I saw it once when I was younger and remembered many different addictions involved, and I thought I would look at it through a different lens after taking this class. The movie involves drug addiction (inhalants and cocaine), alcohol addiction, and anorexia.

General Overview:

            The general overview of the movie includes an adolescent girl, Tracy, who wants desperately to fit in with the popular crowd. She lives with her mother, brother, and little sister. Her parents are divorced and she very rarely sees her father. Her mother is a recovering alcoholic, and her mother’s boyfriend is a recovering cocaine addict. Tracy then meets a girl at school named Evie who is a bad influence on this honor roll student and encourages her to steal, do drugs, drink alcohol, have sexual encounters, and fight. This movie deals with Tracy’s battle with peer-pressure, drugs, alcohol, and self harm.

Below is a short video clip that summarizes the movie and allows clips of Tracy's addictions to be seen (Inhalants, marijuana, and alcohol). Toward the end of the clip you can see her behavioral addiction to cutting herself as well.

How did the movie’s portrayal of addiction make you feel?

            The movie’s portrayal of addiction made me feel uncomfortable. It was shown in a very personal way and the emotions and feelings felt so real. After studying the side effects in class, this movie allowed the viewers to get a good look at how it affects not only the abuser, but also the entire family. After Tracy’s downward slope in life, grades, and attitude, the entire household was turned upside-down. These were obvious signs that she had an addiction because her life was changing around her actions and took over her leisure time along with her work, school, and family time.

Where you empathetic toward the person with the addiction, or were you angry?

            I felt angry towards Tracy, not empathetic. I should have felt bad for her, because of the situation, but she brought it upon her self very clearly at first. All she wanted to do was fit in with the popular crowd, and she did so by starting to smoke, drink, and steal. This then lead to her cutting herself, which is another behavioral addiction that she could not stop.

How did the characters in the movie react to the person(s) with an addiction?

            The characters in the movie reacted in ways that were detrimental to Tracy. Her original friends, who were hard workers and good students, did not do anything; they just let her go. In fact, outside of the first 15 minutes of the movie they were nowhere to be seen. As for her mother, she is pretty clueless and is constantly busy with her job, boyfriend, and other two children. Her mother does see that something is going on; however it is more serious than she thought, or so she said at the end of the movie when an adult brought all the facts to her attention. Tracy’s mother should have been paying closer attention to her daughter’s life and she would have seen the signals of her additions and been able to help her before it got as far as it did. As for Tracy’s brother, he is distracted by her friend who he thinks is attractive at first, but then notices her constantly getting drunk and high and does not tell anyone because he is getting stoned with his friends every day. Her sister is too young to notice and act upon Tracy’s behavior. Evie, the popular girl who influenced Tracy’s bad behaviors, supports her behavior obviously since she has the same addictions.

Do you believe the portrayal of this addiction and/or societal reaction is accurate, given what you know from your own experiences?

            I believe that the portrayal of the addictions and societal reaction is pretty accurate. After having been a teenager, I can understand the peer pressure aspect, but not the desire to do drugs, steal, and cause self-harm. However, because Tracy’s mother is a recovering alcoholic, and her boyfriend is a recovering cocaine addict, they both did not see her behaviors changing and did not act to help Tracy. They should have seen the beginning warning signs and tried to get her help before the situation escalated. That aspect of the movie I feel was a little off, unless they really were too busy to notice or in denial, which is possible. Tracy’s addictions made her moody, angry, change her normal schedule, and an uncontrollable desire to fulfill her different drug and behavioral addictions.

How can you connect what you’ve learned through assigned readings and in-class discussions with what you observed in the movie?

            Through assigned readings and in-class discussions I was able to make many connections through the movie. Tracy uses inhalants to get high with her friend and it distorts her thinking and feelings. She yells, “Hit me! I can’t feel it!” In response her friend, who is also high, hits her. She also said, “ I think my nose is melting off,” and is hearing sounds that are not really there. Tracy and her friend both go to all different extents to get drugs. They are dependent on them. On numerous occasions, Tracy pays for drugs from a “mysterious man” at the park and does not really know what she is getting or taking. She also does sexual things in exchange for drugs frequently. She then starts smoking and drinking on a regular basis. She is very moody and aggressive, starting fights with her mom and brother. In addition to her drinking and drug addictions she is also showing anorexic tendencies. Her mother asks her on 4 separate occasions if she has eaten and she responds with “No, I’m not hungry!” or “I’m on a diet!” She also makes a comment that if you drink 10 glasses of ice water a day, you burn 300 calories. In addition to the drugs, alcohol, and anorexia, she also cuts herself. It is seen 5 different times throughout the movie. She displays similar actions and behaviors to when she does not receive alcohol. She is fidgety, angry, and is anxious until she gets to a place where she can cut her wrist with what ever she can find (scissors, razor).

Journal Article Response: Co-occurring Conditions

Article Summary:

            This article explains the Better Life group program and how it was developed to help individuals with co-occurring disorders reduce their substance misuse. In the past, the article states that Norway did not integrate concurrent treatments of the two disorders and treated one followed by the second. However, through weekly sessions in close-ended groups for four to six months, the program, Better Life, is now helping individuals overcome their addiction. This is through the use of education about co-occurring disorders, motivational enhancement, social skills training, peer support, and establishing healthy friendships and leisure activities. This program is meant for individuals in the preparation or action stages of change (Grawe, Hagen, Espenland, and Mueser, 2007).

            Nine mental health centers or hospitals were used in the study and agreed to complete two Better Life groups each; this included eighty-two patients. As an implementation of the study, the goal was to examine its effects on substance use and mental health outcomes and to explore individual predictors of outcome. In addition, the main skill areas taught in the Better Life program were problem solving, basic communication, assertiveness, refusing offers to use substances, coping with cravings, and prevention relapses, friendship skills, and developing alternative leisure activities. Individuals that completed the treatment showed significant reductions in substance misuse and improvement in global functioning. Overall, this pilot study supports the Better Life program and suggests that it can improve substance misuse and mental health outcomes (Grawe, et. al., 2007).

Thoughts and Connections:

            The Better Life program was created to help the treatment of co-occurring conditions, which was discussed in our book as a problem for not only the individuals but also helping professionals. The article by Grawe et. al., states how the two conditions are either treated one at a time, or one following the other, not together (2007). This study is trying to solve the problem by addressing the actual conditions both at the same time and was proven successful. I think this is a study that can help other professionals see how treating both conditions together can be successful and help motivate more programs to treat both conditions simultaneously.

            This article also relates to our class discussions in that it is very difficult to diagnose one condition over the other as “primary,” therefore, supporting the idea of treating both the addiction and the mental illness at the same time. This would make the process for the patient and the professional more effective and will hopefully lead to a proper, permanent recovery. Ideally, this is what all helping professionals wish for their patients.

Source:

Gråwe, R. W., Hagen, R., Espeland, B., & Mueser, K. T. (2007). The better life program: Effects of 
          group skills training for persons with severe mental illness and substance 
          use disorders. Journal Of Mental Health, 16(5), 625-634.