The Medical College - Page 29
words below best describes Correll's
response
to this criticism?
A.
Angry
C.
Wounded
B.
Vindictive
D.
Indifferent
30.
In retirement, both Correll and Gosden
were
financially secure. What was the state of
their
friendship in the later years of their
lives?
A.
Their friendship was weakened by the
tur-
moil and controversy caused by the
show,
and they drifted apart.
B.
They remained friends and lived near
each
other in Beverly Hills.
C.
They quarreled bitterly over money
and
parted enemies.
D.
They occupied adjoining suites in the
Bev-
erly Hilton until Correll returned to
Peoria.
Passage V (Questions 31–37)
The process involved in the recovery from
either
chronic alcohol or substance abuse is a long
one, mainly
a lifetime pursuit. AA teaches that an
alcoholic can
never drink again, and it is generally held
that relapse
occurs more often when someone stops going to
"meet-
ings." Although empirical observations such as
these
have caused a considerable amount of doubt in
the past,
a measure of light is now being shed on the
situation.
For example, some of the answers to the puzzle
of
the recovery process are suggested in two
articles pub-
lished in the first issue of the Informer by
O'Brien and
Rosecrans. They focus primarily on the
environmental
contingencies that cause drug-dependent
individuals
problems when trying to stop using a specific
chemi-
cal. Thus, the drug-dependent individual is
faced with
many problems outside of his or her own
internal need
to feel good. For example, drug effects such as
their
self-administration, and the withdrawal
syndrome fol-
lowing chronic use, can be elicited by external
stimuli
previously associated with previous drug use. A
heroin-
dependent individual in recovery may
experience
severe withdrawal symptoms if he or she enters
a bar
or restaurant previously associated with heroin
with-
drawal. Furthermore, an alcoholic when not
under the
influence of alcohol may have difficulty
finding his or
her car when parked during an alcoholic bout,
but can
remember where it is when drinking is resumed.
This
latter phenomena is better known as
drug-induced state
dependent learning, a pharmacological effect
well doc-
umented in the human literature.
Thus, when one considers what a drug can do to
an
individual internally, and in conjunction with
his or her
environment, one wonders how anyone could
become
drug-free under the burden of such effects.
However, it
does happen many times over, regardless of the
odds.
Thus, is recovery a magical phenomena, or is it
scientif-
ically based? The answer is not simple. One
experiment
conducted in rats may help us appreciate what
might be
going on during the recovery process. In this
study,
Esposito et al. (Science 224: 306–309
(1984) at the
National Institute of Mental Health were
evaluating
how electrical stimulation (like ECS) affects
energy
metabolism in rat brains. Two groups of rats
were stud-
ied; one group was allowed to stimulate itself
by press-
ing a lever (self-stimulation); the other group
was
stimulated within the same parameters, but the
stimula-
tion was elicited by the experimenter. The
second
group, thus, had no part in the
electrostimulation of
their brains. Interestingly, even though both
groups of
rats received the same level of stimulation,
the brain
area distribution pattern of increases in
energy metabo-
lism were quite different and contingent upon
whether
rat or experimenter turned on the
stimulator.
This experiment is important, not because it
pro-
vided a specific set of data, but because it
demon-
strated that a specific change in brain
energy
metabolism was controlled by each individual
rat.
The effect on energy metabolism was quite
different
when elicited by the experimenter. This
simple
experiment suggests that each individual, to
recover
from drug dependency, must operate on him or
her-
self. This concept may have importance for two
other
reasons. First, treatment works only when the
indi-
vidual decides to take on recovery. Although
this
may appear to be a logical statement, many good
pro-
fessionals, including some in the areas of
medical
and mental health, do not appear to appreciate
the
difference between treatment and recovery.
Second,
during the recovery process, the individual is
basi-
cally altering his or her behavioral
conditioning and
neurochemistry, which will allow the process to
go
forward. This can be done by extinguishing or
alter-
ing the stimulus properties of the drugs that
the indi-
vidual is dependent on. "Don't drink and go
to
meetings." In scientific terms, the reinforcing
effects
of drugs are extinguished by not using them,
and the
stimulus properties are altered by joining
forces with
people who have also changed their
environments. In
addition, the social reinforcement and support
in AA
is also important to recovery because one is
substitut-
ing alcohol or drugs with people, a much
finer
euphoriant. Therefore, success in recovery may
not
Adapted from John A. Rosecrans, Drug Dependence
Outline,
MCV/ VCU, 1990.
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