Drug and Alcohol Dependence: The Problem, The Solution, and Co-Occurring Disorders (3 hours)

William Loving


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This 3-hour course is comprised of three sections that address the disease concept and how it affects the brain, treatment and recovery, and how to diagnose a co-occurring disorder.

I. The Problem: The Disease of Chemical Dependency

The first section of this course is an explanation of the disease concept of chemical dependency explaining what is meant by disease in this case and describing the problem as a central nervous system disorder or brain disorder. It includes a discussion of how the brain works and the areas of the brain affected. The reward center is discussed and its important role in the disease of chemical dependency is discussed.

Goals and Objectives
Upon completion of the first part of the course the student will:
1. understand what is meant by “disease” when referring to alcoholism and drug addiction.
2. gain some understanding of the workings of the brain and the central role of the reward center in chemical dependency.
3. understand what is meant by “side effects” in reference to chemical dependency.
4. understand why a person with the disease of chemical dependency (alcoholism or drug addiction) cannot safely use any of the substances that stimulate the reward center.
5. understand what is meant by encephalopathy and post-acute withdrawal.
6. learn what is meant by biopsychosocial disease and chronic disease.

II. The Solution

This is a discussion of what is known about treatment or recovery in the chemically dependent person. More detailed discussion of the effectiveness of the 12-Step Programs is discussed and other important elements of “recovery” are outlined.

Goals and Objectives
Upon completion of the second part of the course the student will:
1. understand the difference between abstinence and sobriety.
2. get an appreciation for what is effective and what is known about the treatment of alcoholism and drug addiction.
3. know the difference between recovery and detoxification.
4. have an appreciation of various forms of treatment including cognitive behavioral treatment, motivation interviewing techniques and 12-Step facilitation.
5. have an appreciation for why all reputable programs include the 12-Step Program of AA, NA and CA.
6. have a belief in the effectiveness of recovery from this serious and chronic disease.

III. Co-Occurring Disorders

This is a discussion of one common reason recovery does not work in the alcoholic and drug addict. Often this is caused by the CD person having a psychiatric problem as well. A discussion of how to diagnose this is presented and common diagnoses such as bi-polar illness, major depression, anxiety disorder, PTSD and others are discussed individually.

Goals and Objectives
Upon completion of the third part of the course the student will:
1. have an understanding of when to suspect a dual diagnosis or psychiatric problem in the person who has chemical dependency.
2. attain some knowledge about how to distinguish between post-acute withdrawal problems and a dual diagnosis.
3. have some appreciation of the more common psychiatric diagnoses that show up in the chemically-dependent person.
4. have some appreciation of how to suspect these problems and how to address them when found.

Your Course Instructor:
William Loving, M.D.

Dr. William Loving is a board certified psychiatrist (January 1981) and an addictionist certified by the American Society of Addiction Medicine (April 1989). He graduated from the University Of Texas Medical Branch at Galveston in 1974. He was given the Physician Excellence Award at Seton Shoal Creek Hospital in 1991, and received the Exemplary Psychiatrist Award by NAMI (National Alliance for the Mentally Ill) in 1995. He has 25 years experience treating psychiatric and chemically dependent patients. He is medical director of CORE Health in Dripping Springs, Texas, which is a residential treatment center for disabled psychiatric patients and a post-acute rehabilitation center for traumatic brain injuries. He is also medical director of Texas Star Recovery Program in Austin, Texas, which is a detoxification hospital and inpatient drug and alcohol rehabilitation center. He has written numerous articles on chemical dependency for the Travis County Medical Society Journal, Recovery Today, and the Texas Medical Society Journal

Additional information


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