STUDY GUIDE EXAM2
STUDY GUIDE EXAM2 PSYC 3346
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This 19 page Study Guide was uploaded by Cristina Saiz on Thursday October 8, 2015. The Study Guide belongs to PSYC 3346 at University of Texas at El Paso taught by Dr. Adolfo J. Alvarez in Fall 2015. Since its upload, it has received 96 views. For similar materials see Drugs of Abuse and Behavior in Psychlogy at University of Texas at El Paso.
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Date Created: 10/08/15
Week 5 Drugs of Abuse and Behavior NERVOUS SYSTEM Consists of brain and spinal cord Electrochemical highly complex communicationtransmission system NE UROTRANSMI39ITERS There are many and they all have different functions Dopamine in relation to the eye dilates to see more of the pupil which is just an opening in the eye that allows light in for us to see Acetylcholine in relation to the eye contracts the pupil to make it look smaller Central Nervous System easy to remember because it s centralized it receives and sends information Peripheral Nervous System anything outside the central nervous system Brain is divided into 2 hemispheres and is contralateral contraopposite right hemisphere controls movement of the left side of the body eft hemisphere controls movement of the right side of the body Brain is comprised of neurons I glia cells quotglia comes from glue glial cells nourish and support the neuron they comprise the Blood Brain Barrier Blood Brain Barrier BBB barrier between blood and brain cells if drugs weren t able to cross the BBB we wouldn t feel any effects Dendrites receive information Axon carries information from the dendrites and transports to terminals Myelin sheath speeds up impulse through the axon if myelin sheath becomes deteriorated it causes multiple sclerosis Action potential the action taking place from neuron dendrite all the wat through to terminal didn t really get a definition on this one Synapses have 3 parts presynaptic membrane or terminal end of one neuron synaptic cleft or gap between the synapse postsynaptic membrane or terminal beginning of new neuron Neurotransmitters get sent from neuron to another and bind themselves to receptors RECEPTORS Binding starts the action potential 2 types of receptors 1 Excitatory amp 2 Inhibitory Neurotransmitters are neither excitatory nor inhibitory but receptors are either one or the other depending on where they bind examples meth amp cocaine bind to excitatory receptors heroin amp morphine bind to inhibitory receptors Dopamine DA attaches to excitatory amp inhibitory receptors is produced in the Substantia Nigra there are 5 receptors for dopamine REMEMBER different neurotransmitters have different receptors Agonist drugs 9 mimic the effect a neurotransmitter cocaine amphetamine methamphetamine mimic the effect of dopamine ack of dopamine causes Parkinson s disease difficult of movement effects cognition and motivation excess of dopamine causes some symptoms of schizophrenia pleasurable things release dopamine such as chocolate food laughing sex and kisses PleasureReward Pathway also called Mesolimbic Dopamine Pathway pleasure center of emotions is the limbic system so Mr Alvarez says it makes more sense to tell your partner quotI love you with all my limbic system instead of your heart Psychoactive drugs have a direct or indirect effect 92 10 times release of dopamine which is why drug users say their first time using drugs was the best feeling they ve ever had and because of that they start to use drugs more and more to try and reach that same first effect Acetylcholine Ach attaches itself to 2 types of receptors in the heart inhibitory and muscle movement excitatory involved in activation of muscles attention memory learning Reated to Alzheimer s disease The agonist drug that mimics acetylcholine is nicotine Endorphins attach to inhibitory receptors Endo comes from inside the body orphin comes from morphine so endorphins are morphine produced inside the body agonist drugs that mimic endorphins opium heroin morphine endorphins get released when we experience pain if endorphins were as potent as heroin we would die because we wouldn t feel any pain endorphins also get released when people experience runners high have sex eat chile Glutamate this neurotransmitter attaches to excitatory receptors is involved in memory and learning mimicry an antagonist drug opposes the effects of drugs by blocking the receptors one such drug is PCP aka angel dust it acts on glutamate and is very unpredictable because it can be either an upper or a downer Serotonin aka 5HT9 5Hydroxytryptamine this neurotransmitter attaches to excitatory receptors mimicry agonist drug that mimics the effect of serotonin LSD hallucinogen magic mushrooms peyote MDMA ecstasy involved in depression sleep appetite body temperature sensory perception may feel no pain Telltale sign of PCP use is temperature goes up and because users feel so hot they start undressing Serotonergic Pathway starts in raphe nuclei serotonergic pathways occipital lobe visual cortex of the brain 5HT affected by Prozac antidepressant which is a psychoactive drug but it s not addictive because it does not produce any pleasure in the user Antidepressants are also called SSRIs selective serotonin reuptake inhibitors because they re reabsorbed into the membrane GABA Gamma Aminobutvric Acid attaches to inhibitory receptors the agonist drugs that mimic GABA are alcohol Benzodiazepines 9Xanax valium a Benzodiazepines sedative hypnotics involved in relaxation and sleep Adenosine attaches to inhibitory receptors the antagonist drug that mimics adenosine and blocks these receptors is caffeine is involved Anandamide attaches to inhibitory receptors the agonist drug that mimics anandamide is marijuana classified as mild hallucinogen even though for most people it acts as a relaxant like downers do involved in appetite pain relief sleep Neurotransmitter Reabsorption is when some of the neurotransmitter gets reabsorbed into the membrane Neurotransmitter Breakdown instead of the neurotransmitter being reabsorbed or attaching to a receptor some of them get broken down Psychoactive drugs in uence on neural transmission 0n receptors 0n Neurotransmitters 1 excitation 1 Synthesis production of neurotransmitter 2 inhibition 2 Transportation way they re transported within a cell 3 Storage vesiclessacs 4 Release 5 Degradation how they re broken down 6 Reuptake how they re reabsorbed THE ACTION OF DRUGS PHARMACOLOGY Effects are placed into 2 categories A Subjective 9 user reported experiences nonspecific effects non pharmacological effects B Objective 9 reliably measured effects example marijuana causes tachycardia which is heart rate increase pharmacological effects A NonPharmacological effects 1Characteristics of user gender women have less percentage of water than men amp less alcohol dehydrogenase so the alcohol stays in their body longer Height amp weight shorter or thinner people get drunk faster Foo slows down absorption of alcohol Water more water in your system makes less effect of alcohol in your system Ma sick person would feel the buzz faster Tire a tired person would also get the buzz faster Expectations for example if you have no expectation of marijuana and know nothing about what effects it will have on you it wouldn t be uncommon to feel no effect Mood for example when someone tries hallucinogens for the first time if they feel anxious or scared they will experience what we know as a bad trip Genetics if drug use or alcoholism runs in the family for men it carries onto the next generation Asians experience quotOriental Blush or quotAsian Blush they have a reaction to the alcohol that causes their faces to flush red and may get nauseous and throw up after the first sip 2Setting for example a heroin user would typically hide their drug use and have certain hidden places where they shoot up the drug and these settings can affect the experience of the high B Pharmacological Effects 1Chemical Structure comparing heroin to morphine the molecules in heroin are smaller than the molecules in morphine which causes the heroin to be more potent than the morphine because those smaller heroin molecules are able to get through the Blood Brain Barrier quicker Lipid solubility if it can be dissolved in fat it influences the effects For example Oxycontin used for pain compared to diamorphine heroin influences effects and one is more potent than the other 2Potency is not related to how addictive a drug is You need less dose of a drug to produce that effect There are 5 categories based on abuse potential and if drug has a medical use Schedule I have high abuse potential and has no current medical use Examples marijuana and heroin Schedule II have high abuse potential and current medical use Example oxycontin and medical cocaine the one used for certain types of surgeries like for your nose Week 6 2 Potency measured in terms of weight LSD street name microdot meaning millionth of a gram it takes 4060millionths to produce the effect 3 Dose also influences effects of the drug Example 1 beer compared to 3 beers is a higher dose Marijuana is much more potent than it was back in the 50s because these days they grow marijuana scientifically to increase THC Adulterants Diluting chemicals quotcutsquot when they add other things to the drug to increase the weight and make people pay more for it Also called quotstepped on 4 Route of Administration there are 4 principle routes through which drugs can be delivered into the body oral administration injection inhalation absorption Speedtime of onset the quicker it reached the brain the more pleasurable the high The order of Quickest way 1 to the Slowest way 4 1 Smoking the drug pulmonary method happens in seconds 2 Intravenous injection through veins intramuscular in the muscle like how they administer vaccinesimmunizations or subcutaneously in the tissue underneath the skin 3 Snorting the drug this is intranasal absorption but can also be done sublingually as with nitroglycerin tablets for heart disease patients 4 Oral administration of pillscapsules or drinking alcohol or liquid medication can take several minutes some inmates say that IV injection works faster than smoking the drug Arteries carry blood to the muscles Veins carry blood to the heart 1 Intensity varies with each route of administration 2 Duration of effects the quicker it reaches the brain the shorter the duration of the high 3 Addictiveness Potential the quicker it reaches the brain or the method the higher the addictive potential 4 Fatality the quicker the drug reaches the brain the higher the overdose potential SMOKING and INJECTING produce more fatalities Intravenous IV iniection aka mainlininq people who start injecting have to get over the initial fear of the needle and often some people have someone else inject them instead After repeated injections veins collapse or get infected called quottracksquot Once people start collapsing veins they find other places to inject themselves like their hands or neck Pulmonary inhalants like some types of markers gas cool whip cans computer dusting spray spray paint are typically used by kids because they re available at home Intranasal snorting technical term insufflation Some people take in alcohol rectallyvaginally because the effects are faster because of the thinner membrane in these areas absorb alcohol quicker Inl39ection intramuscular intradermal subcutaneously under skin Subcutaneous injection causes quotskin popping and typically happens with heroinmorphine users can find this in hospital settings and is done on legs because the legs are not seen since they re covered by the scrubs people wear Which drug is most addictivepleasurabledependency pronepotent using rats quotceterus paribus meaning quotall things considered the rats preferred liquid cocaine Crystal meth said to be more pleasurable than cocaine because it produces more dopamine a meth high lasts hours much longer than a cocaine high minutes Percentage of users who become dependent when comparing alcohol cocaine heroin marijuana tobacco LSD stats show that nicotine produces more addicts because it s legal and cheaper about 30 compared to the 10 of alcohol addicts Amphetamines not used in this studyquot Tolerance you need higher dose of the drug to get the same effect Cross tolerance one type of drug develops a tolerance amp a second drug similar to the first doesn t have an effect because it is also tolerant such as sedative hypnotics produce the same effect as alcohol Reverse tolerance alcohol is metabolized in the liver and chronic use of large amounts affects whole body especially the liver STIMULANTS Video about Amphetamine amp methamphetamines cheaper than cocaine Meth is the world s most dangerous drug and is 3 12 more times powerful than cocaine It can be snorted swallowed smoked injected Started in the western US There are 26 million meth users world wide Meth users commit 85 of theft in Oregon Meth causes its users to become hyper paranoid delusional violent t transforms the look of users through METH MOUTH tooth decay in meth addicts At first the user feels euphoric energetic confident then it causes heart to beat faster experience paranoia like the effects of LSD Meth is engineered to keep you awake half the world s users are in Japan In Thailand it s called quotyabaquot and they use it to keep them awake and alert some Thai people say that it helps them work for days without end There is a common hallucination of bugs in the skin Meth has been around since the 50s and can be made at home Some of its active ingredients are found in cold medicines that contain ephedrine or pseudoephedrine which closely resembles dopamine Video said that meth is coming into El Paso from Mexico via underground cocaine tunnels used by the cartel but Mr Alvarez says that s not true and the meth comes in from Arizona but not from El Paso Even the smallest hit of meth can last from 6 to 12 hours Crystal meth is more pure potent and dangerous and it s one of the most addictive substances on the planet according to the video Mr Alvarez opined that meth could have a higher dependency than cocaine because it s more pleasurable the high is longer and it s cheaper than cocaine Week 7 Continuation of Stimulants vary in terms of intensity Least intense caffeine amp nicotine amphetamines cocaine methamphetamines most intense Nervous System Central nervous system runs through the center of the body and consists of the brain and spinal cord Peripheral nervous system runs on the outskirts and contains the somatic and autonomic nervous systems somatic nervous system controls motor like walking and talking autonomic nervous system controls things that are automatic like breathing and your heartbeat Autonomic nervous system is broken down into 2 additional systems parasvmpathetic system example when we are relaxed we are under the influence of the parasympathetic nervous system sympathetic nervous system example when we are angry nervous or afraid we are under the influence of the sympathetic nervous system Sympathetic nervous system when we re afraid or under the influence of stimulants pupils center of the eye dilate to see better saivation is inhibited and causes dry mouth sweating increases blood vessels constrict heart beats faster to get blood to the bodylimbs called tachycardia can also cause cardiac arrhythmia heart loses rhythm blood pressure rises Sympathomimetic Effects stimuants mimic the sympathetic nervous system they bind to excitatory receptors cocaine and meth are agonist drugs and mimic the effects of dopamine Pleasure Reward Pathway in VTA Ventral Tegmental Area also called the mesolimbic dopamine pathway causes 2 to 10x the release of dopamine remember rats prefer cocaine over heroin Comparison of cocaine amp methamphetamine COCAINE attaches to presynaptic membrane amp blocks dopamine transporter METHAMPHETAMINE enhances dopamine synthesisproduction enhances dopamine release amp releases dopamine faster slower breakdown amp longer duration Acute desired effects immediate effects increases alertness reduces appetite energized fatigue goes away workers use it to work long hours changes mood it s an upper so it brings up mood and person feels betterhappier euphoria selfconcept is increased and person thinks they can do anything and everything possible grandiosity enhances sexual performance orgasms under the influence of sympathetic NS and some men say they can last longer some people put it on their genitals to enhance sexual performance and feeling can also be injected into horses for horse races to make them run faster and injected into roosters cocks during cock fights to fight longer Cocaethylene combination of cocaine and alcohol alcohol is a depressant but when combined with cocaine keeps them alert and able to drink more for longer 1 Increases euphoria of cocaine 2 slows down elimination of drugs from the body makes the effects longer 3 but increases risk of overdose Medical Uses Ritalin used for ADHD helps with alertness amp is a schedule drug high abuse potential with medical use Concerta easy to remember concentration Adderal used for ADD Why is it that these drugs are addiction free 9 they are ingested in pill form so they take longer to reach the brain Amphetamines also used for narcolepsy disorder where person falls asleep spontaneously not common also used for extremely overweight people to kill their appetite but only for short term use Cocaine also used for nose surgeries because of its anesthetic effect and it constricts blood vessels to stop bleeding vasoconstriction Acute NonDesired Effects side effects or secondary effects can produce a heart attack tachycardia or arrhythmia death If injected or smoked people engage in a binge or run because the effects are short lasting Rush and crash intense rush of pleasure but when effect stop 5 they crash Very uncomfortable and unpleasant The crash when drug wears off the opposite of good effects happen They go from being energized to having no energy You ll go from a very pleasurable mood to a depressed mood Speedball combining cocaine or meth with a depressant heroin they combine with heroin to make them mellow and lessen the effects of the crash Acute NonDesired Effects produces hallucinations of the tactile form sensation of bugs under the skin IMPORTANT these are called cocainemeth bugs formication High Dose Side Effects hearts attacks high blood pressure OVERDOSE coronary heart disease possible seizures but these are not so common Chronic Side Effects chronic cocaine use creates a hole in the septum from snorting the drug it damages the membranes in septum post nasal drip crack lungs produce chest pain METH MOUTH caused by saliva inhibition dry mouth sugary drinks poor dental hygiene or destruction of enamel caed BRUXISM Effects according to DSM5 Substance Use Disorder Substance Intoxication can also happen to first time users Substance Withdrawal TOBACCO about 23 of the population consumes tobacco younger kids use it more than older adults Some history Aztecs smoked it through reeds or inhaled it like with snuff it spread north to the natives who used it for religious reasons Jean Nicot 1560 was the ambassador who pushed the positive effects of tobacco and the active ingredient was named after him nicotine Raeigh was a british sir who smoked tobacco and one of his dukes or whoever thought his head was on fire because of the big puff of smoke and splashed water on him the Duke brothers made the machine that rolled cigarettes Hiter disapproved of tobacco use 1966 tobacco needed to have Surgeon General s warning on the packs The average age of adolescents start smoking at age 14 Marlboro is smoked in Indonesia even by toddlers and children who are able to consume tobacco Dependence Liability of tobacco is at about 32 Doctors O Dell Carcoba and Cooper all do tobacco research here at UTEP Major classes 1 Stimulants 2 Depressants 3 Hallucinogens Neurotransmitters nicotine is an agonist drug that mimics the effects of Acetylcholine Ach is involved in 1attention 2memory related to Alzheimer s 35keletal Muscles nicotine binds to excitatory receptors Routes of Administration smoking it through a pipe or cigar does not use as many inhalations like a cigarette does snuff9 inhaling it through the nose moist snuff placed in their mouth chewing tobacco Acute Desired Effects M to help people stop smoking through nicotine patches or gum NonMedical 1 Bi phasic effect low doses act as a stimulant higher doses relax this effect occurs in people who have not become addicted 2 Alertness is improved 3 Appetite is slightly decreased 4 Fatigue is reduced slightly 5 Mood slightly elevated nicotine can also act as a laxative People with schizophrenia smoke a lot because the nicotine increases their concentration to about 90 NonDesired Effects 1 Dizziness 2 Headaches 3Nausea 4 Diarrhea 5 Vomiting 6 Weakness 7 Breathing Difficulty 8 Perspiration increase Effects in terms of children RARE shaking tremors9 1convulsions 2death 60mg of nicotine could kill Only 1mg of nicotine through smoking Chronic Effects Tobacco Use Disorder Tobacco Induced Withdrawal typically are opposite of the good effects examplesirritability mood swings headaches Withdrawal can cause sleep disorder ung CANCER Freud died of cancer he was a cigar smoker Secondhand smoke is more deleterious than whatever smokenicotine is inhaled Thirdhand smoke particles in furniture carpeting also found to be toxic relatively new Prenatal effects 15 of Nicotine absorbed by fetus if pregnant mother smokes and is excreted in breast milk smoking makes conception more difficult can cause heavy bleeding spontaneous abortion premature birth low birth weight smaler head circumference correated with SIDS sudden infant death syndrome withdrawal symptoms in baby 2x the risk of tobacco use disorder Mouth cancer when chewing tobacco the more that gets swallowed the more it affects possibility of cancer in areas that swallowed tobacco comes into contact with Vapor vs Smoke Vapor is said to be safer tar free odorless cheaper but unaware of long term effects and the vapor contains formaldehyde Broken Chapters 68 Chapter 6 On My Knees He made a rule against drinking during the day because he was getting cravings for alcohol early on in the day but would violate his own rule when he would go out for lunch breaks By the time he was 29 everything in his life revolved around marijuana alcohol or cocaine When he would pull allnighters he would snort cocaine in the newsroom in the middle of the night when no one was there He was getting nose bleeds more often He met a guy named Jack a former marine now unemployed in Gunther s Tap Room inside the bathroom of this bar and he bought coke off of him They went to Jack s apartment just a few blocks from the bar and he smoked crack cocaine for the first time with a dude he just met inside a bar bathroom He felt the high was so great that he turned his back to all alcohol and marijuana just to find that wonderful high he felt from smoking crack He shared his crack with Jack since Jack had no money but did have the connections to get it and gave him an extra rock or two to reward his hard work Every time they made a crack run they would stay up all night smoking it and after their binge he would buy a 160unce beer and head back home He would go back to jogging every morning going to work every day and spend his nights at home with his wife and dog Mary and Dallas After a while he started to get suspicious ofJack because he was bringing back less cocaine for the same price they first bought it for and going to the bathroom too often during their smoke binges He went off on his own after this and tried to get crack from the usual place him and Jack got it before but there had been an incident with the cops a few weeks earlier where a couple of undercover officers got gunned down so nobody was selling crack in the area When he did find crack that day he smoked it all day in his car driving around to different spots to avoid seeming suspicious His wife knew something was wrong with him but couldn t pinpoint exactly what it was and his father also sensed some stress and emotional instability within him His marriage was a mess as was his job and he thought his marriage was irreparable and he wasn t succeeding at work so he quit and he started working for his parents production company in the city which made him closer to his crack dealers After long weekend binges he would tell himself he wouldn t repeat the experience again but within a couple days the withdrawal would hit and he would leave the office to go buy crack When he would commute to the city in his car he would smoke crack on the way home and drive with his knees He moved in with his dealer stayed there for six days but the place was still unsafe because of all the cops still roaming the streets People in need of a fix stole from each other or robbed people the place was becoming unlivable He didn t sleep or change his clothes those six days that he stayed there and on that 6th day he called his wife to tell her he was fine because she had no idea where he had been all that time After his call to Mary she called his mother who called a friend of his dad who was a lawyer and they both went searching for him in Harlem They finally found him had a scene outside the apartment complex he left but definitely not with his mom and lawyer He smoked the entire way back home Mary didn t say a word to him when he arrived just went upstairs and went to bed He showered and for the first time in 6 days looked up into the mirror but could no longer recognize the person staring back at him whose skin was now gray freckles gone and burns on his lips and chin Broken chapter 7 Psych Ward He s going to St Vincent s hospital in Long Island for counseling Mary thought it was a short term alcohol problem but when the man taking his information asked him why he was there he admitted to having quota love affair with alcohol and cocaine He went back into the waiting room to tell Mary the truth about him and she was shocked to learn what he was She turned away from him and almost fainted in the foyer outside the waiting room They took him into counseling on the 5th floor of the hospital but he hated it in there and wrote a letter to be transferred elsewhere to another rehab clinic because he felt he was nothing like the people who were admitted there He felt superior to these people who were also addicts or alcoholics or both They were able to smoke in the community room and all the smoke in the psych ward drove him crazy He smoked along with the rest of them but still complained of all the smoke smell everywhere A few days after arriving at the hospital psych ward he called Jeffrey his dealer to tell him sorry for disappearing and he would see him as soon as he got out He started writing in the journal his mom left with him and was writing about everything he had felt about ruining his marriage and how much of a failure he felt like for letting drugs and alcohol affect him so terribly One day his psychiatrist had him tell his whole story of getting into drugs from beginning to end afterwards he felt cleansed of his past wrong doings and decided he was a part of his group therapy now that he shared this new intimacy with them and being on the same level as them One day Mary went to visit him and she told him how she felt cheated and used by him and how all she ever wanted was to be close to him and be with him always but that he was never around and he was always off doing other things She doesn t feel safe anymore so she had the locks changed and told Cope that he wasn t allowed back in the house until she felt safe enough for him to come back He felt his life was broken because he didn t know how to handle life or his emotions since that was why he started taking drugs in the first place to be able to deal with life He started to withdraw from everyone at the psych ward and refused to talk during AA meetings claiming he needed time to think His psychiatrist told him he had to come to terms with the conflicts he had with his father and so he wrote his dad a letter about how he felt about him and how he wanted to be just like him or better than him by age 30 yet there he was addicted to cocaine and alcohol He never did share that letter with his dad though After 17 days in treatment he was finally able to take a free day outside of the psych ward he met with his parents for lunch and then went to church for an AA meeting He had ten minutes to spare and it seems like he s thinking about taking off to Harlem to get crack but in the end goes inside the church and takes his seat until the meeting starts Broken Chapter 8 Hazelden On a flight to Minnesota and he s panicking as the beverage cart is coming his way He was eager to get to Hazelden as soon as he got into the car and had many questions to ask the driver about it as they drove When he got there to Hazelden he felt at ease peaceful accepted He checked in and signed paper still feeling like he was better off than most people that were there already and he told himself he was better than all the people that first get admitted there He realized that he and his roommates only had one thing in common their addiction They shared their stories with one another and Cope came to realize that their addiction was the greatest bond they had He describes the differences between the psych ward and Hazelden and how he was a part of the community there at Hazelden and also how it has no real end or beginning because you re moving at a steady pace and even when you get newcomers or people graduate from the program it still exists and keeps moving forward The psych ward was very different because he distanced himself from everyone and isolated himself because everything there was so awful like the food the physically sick or mentally ill people and all the smoke ruining the psych ward Mary refuses to go to family weekend and Cope tells himself he isn t giving up on their marriage and he ll let whatever happens happen and to let quothigher authority on issues surrounding his marriage decide what will happen He had to write about how he was feeling and spoke about feeling helpless in his marriage and how phone calls made him feel hurt because he wasn t able to be there for support of his parents and their successful productions and not able to be there with his wife who didn t want anything to do with him right now His counselor Keith told him to stop sugarcoating his feelings and stop feeling sorry for himself and go deeper into his feelings and thoughts on things Cope is frustrated that things are not just falling into place throughout his being sober and his counselors keep telling him to let it all alone and that life will happen when it wants to happen and that he can t force it to just fall into place on his time and his schedule They dropped some news on him about going to a halfway house after he gets out of the 28day program at Hazelden and Cope wants to stay in control of his own situation and fight and argue but all his peers tell him he better go because it s the smart option and that they wouldn t suggest a halfway house if he didn t really need it He accepts the fact that he ll have to go because he doesn t want everyone at Hazelden to lose respect for him He s feeling powerless over his disease and his career and schedule because he was recommended to go to the halfway house and though he doesn t HAVE to go he wants to get better and stay better and never relapse He s upset that he has no way to mend his marriage while he s in that halfway house and how it makes a huge 6 month gap in his resume His counselor keith keeps telling him that he s in denial and unable to claim his identity of being an addict He says he was presented many quotteachable moments but was always waiting for something bigger to happen and was always struggling for control and wanted his life to be perfect all the time but all that would make him anxious and he would start thinking about getting high An incident happened with Eric who just so happened to be one of Cope s role models in the program And it was found out that Eric had been taking jogs to a nearby town and buying a pint of liquor and finishing it before his jog back to Hazelden Cope never spoke with him again after that This incident also had him questioning how was he going to be able to overcome his disease when even one of his own role models couldn t His wife no longer wants him to call or write to him She could no longer deal with what was happening between them He feels he ruined their marriage and was ashamed of the damage he caused and how wounded she was living alone He was leaving it in God s hands because he no longer knew what to do Cope s parents attended the family program where they learn about addiction and how it is designed to help the family cope with the disease and teach them how it s not their fault and to hate the disease not the person That was a tough week for him and his parents because they have to share all the hurt that was caused while he was not in his right mind and on drugs His dad got emotional but since they re both men they don t comfort each other because men just don t do that He apologized to his parents for what he s done That night he had an extremely vivid dream about using crack woke up and wasn t even sure it was a dream The craving hit hard just then and he fought hard to make it go away by remembering why and where the cravings really come from They happen because the brain has been changed by drug use but quotwhen your own brain conspires against you maybe the only way to gfight back is to dig deep inside yourself and find the spiritual courage to hole on and stay the course
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