Psychopharmacology – counselorssoapbox video

Psychopharmacology – counselorssoapbox video

Why do drug effects differ? Tolerance, withdrawal, and cravings. Physical and psychological characteristics of the user all play a role in drug effects.

 

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Does Alcohol make you happy or angry?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Bottles of alcohol.

Alcoholic Beverages.
Photo courtesy of Pixabay.com

Set and Setting change perceptions of drug use.

Set and setting, the impact of places and mood on drug user’s experiences plays a large role in the way alcohol and drugs affect the user’s mood and behavior.

Not everyone who takes the same dose of a drug has the same experience. One person who drinks becomes angry and another happy. The time and place of drug use influence the way in which a drug user or problematic alcohol drinker may be affected by their particular drug of choice.

We need to understand these influences to explain why two different people may describe their experience of using a drug in very different ways. The same person may also experience one drug differently at different times. Here are some ways set and setting may alter the drug user’s perceptions.

Set – Mindset matters.

What you expect a drug to do is likely to be the result you get. Well sort of. First the why and then the why not.

Two drinkers each consume the same amount of the very same alcoholic beverage. One becomes angry and combative and the other becomes happy and mellow. Why? Isn’t a drug a drug?

The effects alcohol and other drugs have on people vary with the mood they have when they consume that drug. If someone drinks because they are angry they are more likely to become increasingly angry. The alcohol’s disinhibiting effects allow them to take action, express that anger in ways they would not express it if they were sober.

A happy person, expecting to become happier while drinking, will find that is exactly what happens.  Again disinhibited they may act on that celebratory mood, dance on the table or kiss a stranger but believing that alcohol will make them happy they will become happier.

Sometimes, at least partially, a drug users expectations will override the actual effects of the drug. Mindset also has to do with the reasons for using a drug.

When you take a medication to control pain you are less likely to develop a problem than when you use a drug to change the way you feel emotionally. See physical pain may go away or you may become used to it. But using a drug or alcohol to change the way you feel increases the risk that you will use more and more until eventually that drug no longer makes you feel better but you need it just to feel normal.

Drinking or drugging to change the way you feel is one of the riskiest ways to use substances. Why? Because it works so well. Once you begin using drugs and alcohol to change the way you feel you risk becoming dependent on that drug to change the way you feel.

Setting – where you use a drug matters.

The effect of setting is often underestimated. This leads to strong disagreements about the nature of drug use and addiction.

A patient takes a drug in the hospital. Say they are given morphine for pain. Despite substantial doses over a number of days most people who receive pain medication in a hospital setting do not go on to become addicted.

If that same person were to purchase the very same quantity of this same drug in an alley, there is a high likely hood that addiction would result.

Some religious groups use wine as a part of their service. People rarely behave inappropriately as a result of that one drink at church. But let that same person have a glass of wine late at night in a bar and there is a chance, maybe a good one, that they will behave in a way that they do not normally act.

Drugs, legal and illegal, become a part of the ritual during which they are used. If your ritual is to get high, use all the drugs you can and act violent, that is what you will do. If you believe a small quantity of wine will increase your feeling of religious connection that too will occur.

Both set and setting are tied to placebo and nocebo effects. The way in which you perceive a drug’s use and its effects influence the experience you have.

People who are drinking non-alcoholic drinks but believe they have been given drinks containing alcohol begin to act as though they were becoming disinhibited. They may slur their speech, stagger and become loud and boisterous. They may get louder, joke more and do things that in other settings they would be embarrassed to do. The belief that they were drinking alcohol has altered their behavior.

That does not mean that the effects of drugs or alcohol are purely mental. Give those people who had been drinking a non-alcoholic beverage, but thought it contained alcohol, a reaction-time test and they will suddenly sober up and do just fine.

The converse is that people who drink a lot and develop a tolerance may feel they are not drunk at very high blood alcohol concentrations and with tremendous loss of coordination. While they may think they are fine, those who drank a lot will fail a sobriety test in the lab or in the field.

In any discussion of drug use and abuse, we need to keep in mind the psychological as well as the physical effects of those drugs. Where people use, the setting, and what they are thinking when they use, the mindset, may affect their perceptions of the drug and the risk of developing an addiction or other problems with usage.

Set and setting may alter the way the experience feels but that does not mean that the mind is strong enough to undo the effects of substances. You can think your way into addiction but you can’t think yourself sober. Being clean and sober takes action also.

For more on this see:

Why not everyone ends up addicted to pain medication – set and setting

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Why not everyone ends up addicted to pain medication – set and setting

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs

Medications.
Photo courtesy of Pixabay.com

Psychological factors can affect the addictive potential of drugs.

Some people with chronic pain are able to take pain meds for a long period of time with no apparent addiction problem.

Other people can become addicted to a pain med after using a single prescription.

A major factor in this outcome is a thing drug counselors know as set and setting.

The way you perceive the use of a medication or drug may have more of an effect on the results than the actual chemistry of the medication.

Both “set” and “setting” influence these effects.

Set refers to “mindset” not the taking of drugs on a Hollywood movie set. The drug will produce larger effects in the direction you expect than the opposite direction. This is similar to the things we have talked about as placebo and nocebo effects.

Someone who is in a bad mood, who drinks when angry, is likely to become more angry and violent when drinking. Another person at the same party, thinking that this is a happy occasion will likely become more outgoing and uninhibited. Both people are taking the same drug, in this case, alcohol, but the results conform to the expectations or mindset of the user.

The place matters – setting.

A single glass of wine will affect someone differently if consumed at a religious ceremony than if consumed in a bar late at night. Drinking some wine as part of a ceremony may be relaxing or spiritual, that same glass of wine consumed at a party may result in the person consuming the wine becoming more sexual rather than more spiritual.

What does all this have to do with abuse of prescription pain medications?

People who take prescribed medication, say morphine or an opioid, in the hospital when it is prescribed for pain are at low risk to develop an addiction. That same person who has taken large amounts of morphine in the hospital with no apparent ill effects is at high risk to develop an addiction if they purchase a single prescription from a dealer in the alley. The difference is in the setting in which the drugs are consumed and the purpose for which they are used.

Unfortunately, many of us can’t tell the difference between physical pain and emotional pain. Taking drugs for emotional pain, especially pain medications is a high-risk behavior. Those illicit meds can quickly become an addiction.

Recently we have seen a huge increase in teens and young adults who are abusing prescription meds, often stolen from older family members. While grandma may take a morphine pill every day for pain and not develop the signs and symptoms of a psychological addiction the grandson who steals those meds and uses them to get high can quickly become addicted both psychologically and physically. (See the post on Grandma as a drug pusher.)

What you are thinking about and where you are when you take drugs or medications can and does affect the results you get and the potential for addiction.

The recognition of set and setting points us to a better understanding that the psychological factors in drug addiction are far more powerful than the physical effects in a great many cases.

If you come to believe that you “need” your drug of choice to function well, that you can’t do things without your drug to get you through, even if that drug has a low abuse potential you are at risk to develop a psychological addiction to that drug.

Consider your own drug use and how set and setting may be affecting the results of that drug use.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.