Addictionology
Spot the Pattern
What’s the Payoff?
Sounds True… Is It?
Plot Twist
100
Is an “addictive personality” an actual clinical diagnosis?
Answer: No. People can have traits and risk factors that make addiction more likely, but “addictive personality” is not a clinical diagnosis.
🎧 Play: https://www.alieward.com/ologies/addictionology
Start: 47:12
“Does it ever bother you when people say addicting versus addictive grammatically?”
Stop: 49:20
“Well, it’s also that reward circuitry of the brain, because if a little bit makes me feel good, then I want a lot. Some of our brains are just kind of built that way.”
Bonus Question (100): “How might saying ‘I have an addictive personality’ affect what someone believes they can change?”
100
After an argument, Jordan suddenly wants to use. What role did the argument play?
A trigger: something that brought on an urge to use.
100
“I feel awkward at parties. When I drink, talking feels easier.”
What payoff is this person looking for?
Confidence or relief from social anxiety.
100
True or False:
“If someone really wants recovery, they won’t have cravings.”
False. Cravings can happen even when someone strongly wants recovery. An urge is not a decision.
100
Jordan gets an invitation to a party where people will be using. Jordan wants to see friends but is worried about going.
What’s one way to change the plan?
Suggest another way to hang out, like getting food with a friend somewhere else.
200
According to Erin Parisi, why might a calm, reliable relationship feel boring to someone used to hot-and-cold relationships?
Answer: They may be used to the excitement and intensity of unpredictability. Stability can feel less exciting by comparison.
🎧 Play: https://www.alieward.com/ologies/addictionology
Start: 1: 16: 08
“Kim Edgar wants to know: I have heard something about addiction to stress being a thing. Is this a thing?”
Stop: 1: 17: 24
“There are people who are maybe addicted to the thrill or the excitement. That’s a type of stress.”
200
Sam keeps imagining using and feels pulled toward it, but hasn’t used. What is Sam experiencing?
A craving: a strong urge or desire to use.
200
“The evening feels empty. Using gives me something to look forward to.”
What payoff are they looking for?
Excitement, pleasure, or relief from boredom.
200
True or False:
“If someone stops using drugs or alcohol for over a year but still has the problem they used it to cope with, they may feel pulled to use again.”
True. Unmet needs or ongoing distress can keep pulling someone toward using. Recovery can include finding other ways to meet those needs.
200
Every Friday, Sam gets paid, finishes work, and heads toward the same place to buy drugs.
What could Sam change before leaving work?
Plan a different route and arrange to meet a supportive person right after work. Either change earns credit.
300
Besides copying each other’s behavior, why might people in the same family be drawn to similar substances?
Answer: They may share inherited vulnerabilities or mental health conditions and try to manage similar symptoms with substances.
🎧 Play: https://www.alieward.com/ologies/addictionology
Start: 49:20
“Studies – including some with twins – have shown that heritability for a substance use disorder is about 50%…”
Stop: 50:10
“Think undiagnosed ADHD in family members who choose stimulants or heritable anxiety and the inclination to use downers.”
Quick clarification: This is one possible explanation, not a way to diagnose someone based on their substance use. ADHD is linked with increased substance-use risk, but that does not mean everyone with ADHD misuses stimulants or that prescribed treatment causes addiction.
Bonus Question (100): “How could recognizing an untreated condition change the kind of help someone needs?”
300
Alex thinks, “I’ve had a terrible week. I deserve it just this once.” What is this thought doing?
Giving permission to use.
I'll Accept:
Making an excuse
Bargaining
Rationalizing
300
“When I use, I can put off thinking about my breakup for a while.”
What is the immediate payoff—and what stays unresolved?
Temporary escape from emotional pain. The loss and feelings still need attention.
300
True or False:
“Returning to use means all the progress someone made is gone.”
False. Skills and progress aren’t erased. Returning to use signals a need to reconnect with support and reassess the plan.
300
After an argument, Alex thinks, “Forget it. I’m using tonight.” Alex hasn’t acted yet.
What could create some space between that thought and the next move?
Pause and call someone supportive before making the next move. Accept another realistic way to delay acting and get support.
400
In the original Rat Park studies, which rats generally drank more drug solution:
1. Rats housed alone
2. Rats living in an enriched space with other rats, or
3. Both rats used same amount of drugs?
Answer: The rats housed alone.
🎧 Play: https://www.alieward.com/ologies/addictionology
Start: 27:08
“There was a study done on rats that was talked about at a conference I went to that always stood out to me.”
Stop: 30:29
“As I sat here writing this alone in my apartment, I thought – maybe I should be in a coffee shop instead. With other little rats. That sounds fun.”
Quick Clarification: Erin initially says cocaine, but the original Rat Park studies used morphine. The findings suggest that environment matters; they do not establish that companionship alone cures addiction.
Bonus Question (100): “What would your human version of Rat Park have in it?”
400
Taylor uses, misses work, and feels ashamed. Taylor then wants to use to escape that shame. How is the cycle feeding itself?
The consequences of using become a reason to use again.
400
“Most of my friends use together. I don’t want to be the only one left out.”
What payoff goes beyond the substance itself?
Belonging or connection: feeling included.
400
True or False:
“Once someone understands their addiction cycle, knowing better should be enough to stop it.”
False. Knowing the pattern helps, but changing it takes practice and may require treatment and support.
Clip 1(stop at 3:34): Berenstain Bears: The Bad Habit
https://youtu.be/vQIwxWRzhnI?si=HHHRLt37v4M2Pz8-&t=171
Clip 2 (stop at 9:41): Berenstain Bears: The Bad Habit
https://youtu.be/vQIwxWRzhnI?si=biTC_U0dlQQv7cgO&t=500
Sister needed help with her worry about fractions, not just reminders to stop biting her nails. Addiction is more complex, but the same question can help: What needs support underneath the behavior?
400
Taylor stopped using, but evenings are still lonely. “Just distract yourself” hasn’t helped much.
What change could address what Taylor actually needs?
Build regular connection into the evening: a call, a peer support meeting, or an activity with someone.
500
Besides reducing shame, name one practical reason it matters that addiction is recognized as a disease.
Answer: It supports access to treatment, insurance coverage, research funding, and medication development.
🎧 Play: https://www.alieward.com/ologies/addictionology
Start: 37:19
“Sometimes people ask why it matters if we consider addiction as a disease…”
Stop: 39:18
“The more we see it as a disease and the more we acknowledge that it needs to be treated like one, the more help there will be.”
Quick Clarification: Her statement that there would otherwise be “no treatment options” is too absolute. It's true that recognition supporting funding and access is important, but not the only way treatment can exist.
Bonus question (100): “What’s the difference between blaming someone and asking them to take responsibility?”
500
Riley used to chase a high. Now using is mostly about getting rid of feeling bad. What changed about what keeps the cycle going?
The payoff shifted from getting pleasure to getting relief.
500
Two people use the same substance. One wants excitement; the other wants to numb grief. Why might they need different recovery strategies?
Their use serves different needs. One may need rewarding activities; the other may need support with grief. Accept other reasonable examples.
500
True or False:
“Something can feel helpful right away and still make life harder later.”
True. Short-term relief and long-term harm can happen with the same behavior.
500
Riley used after a month without using and thinks, “I ruined everything. I might as well keep going.”
Name one thought AND one action that could interrupt the cycle now.
Thought: “This doesn’t erase my progress. My next step still matters.”
Action: Tell a treatment provider or supportive person what happened and ask for help with the next step.