Der periodische Suchtanfall im Therapieverlauf

  • H. Kampe
Part of the Suchtproblematik book series (SUCHT)

Zusammenfassung

Der Begriff „periodischer Suchtanfall“ meint einen Zustand, den Drogenabhängige in ihrer Sondersprache „Schußgeilheit“ nennen. Es ist ein problematischer Begriff, da er einem rätselhaften Phänomen Eigenschaften als gegeben unterstellt, deren empirische Untersuchung zu widersprüchlichen Ergebnissen führt. Die vorgestellten Ergebnisse einer empirischen Untersuchung zu diesem Problem zeigen zunächst, daß Therapeuten das Drogenverlangen und die mit ihm verbundenen Probleme der Klienten differenziert beobachten können. Während der Behandlung treten bei ca. 75% der Klienten aus therapeutischen Gemeinschaften Drogenverlangenskrisen auf. In diesen Krisen stehen Drogenverlangen bzw. Schußgeilheit, entzugsähnliche Symptome und Euphoriekopien im Vordergrund. Diese Erscheinungen sind negativ mit der Abstinenzdauer korreliert. Darüber hinaus konnte gezeigt werden, daß die Reagibilität der Befragten auf bestimmte Auslösereize mit spezifischen Erfahrungen aus der Drogenvergangenheit und mit der Besetzung des Bewußtseins durch drogenrelevante Inhalte zusammenhängt. Die Ergebnisse stützen Wiklers Theorie vom konditionierten Entzugssyndrom. Nur ein Drittel der Befragten hatte aus früheren Erfahrungen mit Rückfällen etwas für die Bewältigung der Drogenverlangenskrisen gelernt.

The Periodic Craving for Drugs in the Course of Treatment

Summary

The periodic craving for drugs is a state referred to by drug dependent individuals in their argot as “crazy for a shot.” This craving is assumed to have certain characteristics, but empirical studies lead to contradictory findings. One empirical study on this problem found that therapists are able to make detailed and specific observations about their clients’ craving for drugs and the associated problems. In therapeutic communities, about 75% of the clients experience crises relating to an intense desire for drugs at some point during the treatment program. The predominant features of these crises are a craving for drugs, withdrawal-like symptoms, and an intense desire for a euphoric experience. These phenomena are negatively correlated with the duration of abstinence. Furthermore, the likelihood of certain stimuli triggering the craving for drugs is related to specific experiences in the subjects’ drug career and to the degree that the subjects are currently preoccupied with drug-related matters. The findings support Wikler’s theory of conditioned withdrawal symptoms. Only one-third of the subjects had learned anything of use in coping with such crises from their past experience with relapses.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Brown J (1976) The relationship of environment and stress to relapse among post addicts in a therapeutic community. Dis Ab Int 37 (2b): 1000–1001Google Scholar
  2. Brown BS, Gauvey SK, Meyers MB, Stark SD (1971) In their own words: addict’s reasons for initiating and withdrawing from heroin. Int J Addict 6: 635–645Google Scholar
  3. Chaney E, Roszell DK, Cummings C (1982) Relapse in opiate addicts: A behavioral analysis. Addist Behav 7: 291–297CrossRefGoogle Scholar
  4. Deissler K (1977) Der periodische Suchtanfall. Schweiz Ärztezeitung 13: 514–518Google Scholar
  5. Gritz ER (1980) Smoking behavior and tobacco abuse. In: Mello NK (ed) Advances in substancs abuse. Behavioral and biological research, vol I. J AI Press Inc., Greenwich, Connecticut, pp 92–158Google Scholar
  6. Haertzen CA (1974) An overview of addiction research center inventory scales (ARCI): An appendix and manual of scales. DHEW Publication No. (ADM) 74–92. National Institut on Drug Abuse, Washington, DCGoogle Scholar
  7. Kampe H, Kunz D (1979) Forschungsergebnisse einer von der DHS geförderten Untersuchung eines lerntheoretisch begründeten Behandlungs- programmes für Drogenabhängige. Frankfurt/M. (unveröffentlicht)Google Scholar
  8. Kampe H, Kunz D (1980) Über die Rückfälligkeit von Drogenabhängigen. Suchtgefahren 26: 165–187Google Scholar
  9. Kampe H, Kunz D (1981) Sprachliches Interaktionsverhalten als Parameter des therapeutischen Prozesses. In: Keup W (Hrsg) Behandlung der Sucht und des Mißbrauchs chemischer Stoffe. Thieme, StuttgartGoogle Scholar
  10. Kampe H, Kunz D (1983) Was leistet Drogentherapie? Beltz, Weinheim Kampe H, Kunz D (1984) Integration und Fehlanpassung Drogenabhängiger nach der Behandlung in einer Therapeutischen Gemeinschaft. Prax Kinderpsychol Kinderpsychiat 33: 49–54Google Scholar
  11. Kampe H, Kunz D, Kremp M (1986) Sondersprachgebrauch Drogenabhängiger in ihren Lebensläufen. Suchtgefahren 32: 103–111Google Scholar
  12. Keller M (1972) On the loss-of-controll phenomenon of alcoholism. Br J Addict 67: 153–166CrossRefGoogle Scholar
  13. Kolb L (1925) Pleasure and deterioration from narcotic addiction. Ment Hyg 9: 699–724Google Scholar
  14. Kolb L (1927) Clinical contribution to drug addiction: The struggel for cure and the conscious reasons for relapse. J Nerv Ment Dis 66: 22–43CrossRefGoogle Scholar
  15. Kolb L (1939) Drug addiction as a public health problem. Scient Month 48: 391–400Google Scholar
  16. Lindesmith AR (1937) The nature of opiate addiction. University of Chicago Press, ChicagoGoogle Scholar
  17. Ludwig AM (1986) Pavlov’s “bells” and alcohol craving. Addict Behav 11: 87–91PubMedCrossRefGoogle Scholar
  18. Ludwig AM, Stark LH (1974) Alcohol craving: Subjective and situational aspects. Q J Stud Alcohol 35: 899–905Google Scholar
  19. Marlatt GA (1978) Alkoholverlangen, Kontrollverlust und Rückfall: Eine kognitive Analyse des Verhaltens. Wien Z Suchtforsch 4:19–24 (1. Teil); 1979, 1: 11–20 (2. Teil)Google Scholar
  20. Marlatt GA (1979) A cognitive-behavioral model of the relapse process. In: Krasnegor NA (ed) Behavioral analysis and treatment of substance abuse. NIDA Research Monograph 25. Rockville, MDGoogle Scholar
  21. Marlatt GA, Gordon JR (eds) (1985) Relapse prevention. Guilford, New YorkGoogle Scholar
  22. Martin WR (1972) Pathophysiology of narcotic addiction: Possible roles of protracted abstinence in relapse. In: Zarafonetis CJD (ed) Drug abuse - Proceedings of the International Conference. Lea & Febiger, Philadelphia, pp 153–159Google Scholar
  23. McAuliffe WE (1982) A test of Wikler’s theory of relapse: The frequency of relapse due to conditioned withdrawal sickness. Int J Addict 17:19– 33Google Scholar
  24. McAuliffe WE, Gordon RA (1974) A test of Lindesmith’s theory of addiction: The frequency of euphoria among longterm addicts. Am J Sociol 79: 795–809PubMedCrossRefGoogle Scholar
  25. McLellan AT, Childress AR, Ehrman R, O’Brien CP, Pashko S (1986) Extinguishing conditioned responses during opiate dependence treatment turning laboratory findings into clinical procedures. J Subst Abuse Treat 3: 33–40PubMedCrossRefGoogle Scholar
  26. Mendelson JH, Mello NK (1978) Heroin self-administration: An operant analysis. In: Krasnegor NA (ed) Self-administration of abused substances: Methods for study. NIDA Research Monograph 20. Rockville, MDGoogle Scholar
  27. Meyer RE, Mirin SM (1979) The heroin stimulus. Plenum, New YorkGoogle Scholar
  28. O’Brien CP, Chaddock B, Woody G, Greenstein R (1974) Systematic extinction of addiction associated rituals using narcotic antagonists. Psychosom Med 36: 458Google Scholar
  29. O’Brien CP, Greenstein R, Ternes J, McLellan AT, Grabowski J (1979) Unreinforced self-injections: Effects on rituals and outcome in heroin addicts. In: Harris LS (ed) Problems of drug dependence 1979. NIDA Research Monograph 27. Rockville, MD, pp 275–281Google Scholar
  30. O’Brien CP, O’Brien TJ, Mintz J, Brady JP (1975) Conditioning of narcotic abstinence symptoms in human subjects. Drug Alcohol Dep 1: 115–123CrossRefGoogle Scholar
  31. O’Brien CP, Ternes J ( 1977 a) Conditioning as a cause of relapse in narcotic addiction. In: Gottheil E (ed) Addiction research and treatment: Converging trends. Pergamon, New York, pp 124–132Google Scholar
  32. O’Brien CP, Ternes JW, Grabowski J, Ehrman R (1981) Classically conditioned phenomena in human opiate addicts. In: Thompson T, Johanson CE (eds) Behavioral pharmacology of human drug dependence. NIDA Research Monograph 37, Rockville, MD, pp 107–115Google Scholar
  33. O’Brien CP, Testa T, O’Brien TJ, Brady JP, Wells B (1977 b) Conditioned narcotic withdrawal in humans. Science 195: 1000–1002Google Scholar
  34. O’Brien CP, Testa T, Ternes J, Greenstein R (1978) Conditioning effects of narcotics in humans. In: Krasnegor NA (ed) Behavioral tolerance: Research and treatment implications. NIDA Research Monograph 18. Rockville, MD, pp 67–71Google Scholar
  35. Scholz H (1986) Die Rehabilitation bei chronischem Alkoholismus auf der Grundlage eines verlaufsorientierten Therapiekonzepts. Enke, StuttgartGoogle Scholar
  36. Sideroff SI, Jarvik ME (1979) Conditioned heroin responses as an indication of readdiction liability. In: Harris CS (ed) Problems of drug dependence 1979. NIDA Research Monograph 27. Rockville, pp 168–174Google Scholar
  37. Sideroff S, Jarvik ME (1980) Conditioned responses to videotape showing heroin-related stimuli. Int J Addict 15: 529–536PubMedGoogle Scholar
  38. Stephens R, Cottrell E (1972) A follow-up study of 200 narcotic addicts commited for treatment under the narcotic rehabilitation Act. Br J Addict 67: 45–53CrossRefGoogle Scholar
  39. Teasdale JD (1973) Conditioned abstinence in narcotic addicts. Int J Addict 8: 273–292PubMedGoogle Scholar
  40. Ternes JW, O’Brien CP, Grabowski J, Wellerstein H, Jordan-Hayes J (1979) Conditioned drug responses to naturalistic stimuli. In: Harris LS (ed) Problems of drug dependence 1979. NIDA Research Monograph 27. Rockville, pp 181–189Google Scholar
  41. Ternes JW, O’Brien CP (1982) Psychological and physiological reponse to hydromorphone: An opponent process view of addiction. In: Harris LS (ed) Problems of drug dependence 1981. NIDA Research Monograph 41. Rockville, MDGoogle Scholar
  42. Wikler A (1984) Recent progress in research on the neurophysiological basis of morphine addiction. Am J Psychiatry 105: 329–338Google Scholar
  43. Wikler A (1980) Opioid dependence. Plenum, New YorkGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • H. Kampe

There are no affiliations available

Personalised recommendations