Behavioral Science

142 Deja Review: Behavioral Science
What are the major problems with
using positive and negative
reinforcement treatments?
What is the basic principle behind
detoxification?
What percentage of patients who
become drug-free relapse?
What modalities have been associated
with decreased incidence of relapse?
What is the most likely reason
for relapse?
How can cravings be treated to prevent
relapse?
What are some of the medical effects
of drug abuse?
To use positive reinforcement
treatments, the patient must undergo
detoxification first.
Negative reinforcement treatments
may lead to polydrug abuse,
especially if substitution methods
are used.
Detoxification uses the principle of
substitution with a drug of crossdependence
or different route of
administration to allow for safer,
slower withdrawal from the drug
of dependence. It should not be
used to precipitate withdrawal.
75%—most within the first year
Joining self-help groups → providing
a different type of peer pressure and
reinforcement
Cognitive therapy → helps develop
new and different coping skills
Cravings is the most common reason
for relapse. Cravings are caused by
memories of the positive rewards of
drug use or by conditioning cues that
are endogenous or exogenous.
Cravings may be treated by reducing
the desire for the drug, providing a
substitute for the drug reward, reducing
endogenous cues for cravings (ie, by
using anxiolytics or antidepressants),
reducing the conditional anticipation
of the reward (ie, giving naltrexone
to an alcoholic), or by reducing
pseudowithdrawal symptoms.
Increased risk of lung disease
and cancer
Increased risk of human
immunodeficiency virus (HIV),
hepatitis, and other infections with
intravenous (IV) drug use
Acute and chronic toxicities