The Psychology of Addictive Behaviour

PSYA4

2 hour exam

Specification

MODELS OF ADDICTIVE BEHAVIOUR

The Biological Approach-AO1-

The Biological Approach-AO2-

ReductionistExplains individual differences – e.g. why some become

addicted and others don’t under the same environmental conditions and life pressures. Diathesis-stress model (explains why some are resistant to treatment and more likely to relapse).

Using biological factors alone ignores external factors such as accessibility to gambling opportunities, incentives to gamble (e.g. free bars) and alcoholic drinks while gambling. So maybe pathological gambling is an interaction of predisposition due to biological factors and external factors.

The biological approach does not explain why some types of gambling are more addictive than others. Breen and Zimmerman (2001) found video gambling led to addiction in 1 year, while other gambling (horse racing) took 3.5 years.

The Cognitive Approach-AO1-

The Cognitive Approach-AO2-

The reason behind gambling should be investigated prior to treatment (i.e. If you gamble due to self-medication the cause should be treated first).

The self-medication model is supported by Li et al. (2008) who found that pathological gamblers who gambled to escape the painful reality of life were more likely to be substance abusers than those who gambled for pleasure, and were also more likely to turn to crime to fund their addiction. They will have other means to satisfy their goal.

Benhsain and Ladouceur (2004) gave a gambling-related cognition scale to two groups of university students, one group were statistics trained and one group were not. They found no difference in their susceptibility to gambling-related cognitions; so knowledge does not make you less likely to have cognitive distortions.

Becona et al. (1996) found evidence of major depressive disorders being common among pathological gamblers...

..but depression may not be the cause of gambling; the personal and financial costs of gambling may lead to depression.

The Learning Approach-AO1-

The Learning Approach-AO2-

Operant conditioning is difficult to apply to all forms of gambling. Scratch cards involve a short time period between behaviour and consequence, whereas sports betting involves a longer time period between bet and outcome and has less to do with chance.

Those gamblers who initially gambled due to behavioural conditioning (peers and role models) tend to be less severe gamblers and are motivated to enter treatment. However those gamblers who have other associated problems (anxiety, depression, poor coping skills, negative backgrounds or life events) make for an ‘emotionally vulnerable gambler’ who gambles to relieve emotional states. This group are more resistant to change and treatment must include other behaviours as well as gambling issues.

This explanation does not take into account why very few people become addicted to gambling when so many people try it at some point in their lives. There must be other psychological factors involved too.

MODELS OF ADDICTIVE BEHAVIOUR

The Biological Approach-AO1-

The Biological Approach-AO2-

Reductionist as it ignores the social contextLeads to pharmacological treatments (e.g. NRT) Van der Bree et al. (1998) studied 188 twin pairs and looked at

dependency and how it was influenced by genetics. There was found to be a stronger link in males than females. In females the genetic influence was found to be 47% stronger in identical than fraternal twins, in males this difference was 79%.

Thorgeirsson et al. (2008) identified a genetic variant on chromosome 15 as an influence on the number of cigarettes smoked per day, nicotine dependence and the risk of developing smoking-related diseases. Those who smoked less than ten cigarettes a day were less likely to have this variant of the gene. Therefore those who have this gene may be more likely to become addicted.

Genomic medicine can lead to advising a change of behaviour in those who are at a higher genetic risk...

...but Gartner et al. (2009) suggest that this is unlikely to be successful given the small association between specific genes and smoking behaviour.

The Cognitive Approach-AO1-

The Cognitive Approach-AO2-

Addiction is about a loss of control, but expectancy theories rarely focus on this important aspect.

In order to change the positive expectancies of smoking behaviour CBT may be necessary, along with nicotine patches (Moolchan et al., 2005). Hurt et al. (2000) found nicotine patches alone were not enough to improve cessation rates in adolescents.

Juliano and Brandon (2004) found that the positive expectancies of smoking (weight control, improved mood and reduced cravings) were linked only to cigarettes and not nicotine replacement therapies; this helps to explain the modest success of these treatments.

There is publication bias in expectancy theories. The research published is mainly positive towards the theory, negative results get less attention. This gives an unrepresentative view of the research area.

The Learning Approach-AO1-

The Learning Approach-AO2-

Peer groups are a primary influence on whether adolescent smoke or use drugs (DiBlasio and Benda, 1993).

Karcher and Finn (2005) found that youths whose parents smoked were 1.88 times more likely to smoke. If siblings smoked they were 2.64 times more likely to smoke. And if close friends smoked they were 8 times more likely to smoke.

Thewissen et al. (2008) presented 33 smokers with smoking cues predicting smoking, and cues predicting smoking unavailability. Results showed that there was a greater urge to smoke when presented with a cue related to smoking unavailability.

Drummond et al. (1990) propose cue exposure as a treatment for smoking. The cues for smoking are presented without the possibility to smoke. This leads to stimulus discrimination (the association between smoking and cue are extinguished) reducing the craving for cigarettes when exposed to that cue.

Planning an answer…

Q. Outline the cognitive model of addiction. (4 marks)A. AO1 –

AO1 –

Q.Discuss one explanation of the initiation of gambling addiction. (4 marks + 6 marks)

R. AO1 – AO1 – AO2 – AO2 – AO2 –

Planning an answer…Q. Outline the biological explanation of smoking addiction. (4

marks)A. AO1 –

AO1 –

Q. Use your knowledge about the initiation of addiction to suggest how gambling addiction might be avoided. (4 marks)

R. AO1 – AO1 –

Q. Discuss reasons why relapse occurs in people with addictive behaviour. (4 marks)

R. AO1 – AO1 –

VULNERABILITY TO ADDICTION

Stress-EVERYDAY STRESS-

AO1

• Addiction is associated with relieving anxiety (self-medication).

• People may drink, smoke, use drugs, gamble etc. to cope with daily hassles such as relationship problems, money worries and workplace stress.

• Stressors may contribute to initiation and maintenance of addictions, as well as to relapse even after long periods of abstinence (NIDA, 1999).

AO2/3

Stress-TRAUMATIC STRESS-

AO1• People exposed to severe stress

are more vulnerable to addictions, especially children who have experienced parental loss or child abuse.

• PTSD (post-traumatic stress disorder) is also linked to addiction. For example, Driessen et al. (2008) found that 30% of drug addicts and 15% of alcoholics have suffered from PTSD.

• However ‘mere trauma’ (as distinct from PTSD) was not sufficient to lead to an addiction

AO2/3 Smokers say they smoke to reduce stress,

but smoking actually increases stress levels. So stress may be a risk factor for smoking addiction but the addiction doesn’t have the desired effect. Remember though, that once a smoker has taken up smoking, cigarettes have a stress relieving quality due to withdrawal symptoms.

Stress may create vulnerability in some but not all people. Cloniger (1987) suggested that there are two different kinds of alcoholics:– Type 1 primarily drink to reduce tension (and

are more likely to be female and prone to anxiety/depression)

– Type 2 individuals drink primarily to relieve boredom (and have a tendency towards risk taking).

Therefore stress may explain vulnerability for some (the Type 1s) but not all people.

Peers-Social Learning Theory-

AO1• Peer pressure is a common reason for why

adolescents start taking drugs or smoke. • Research suggests that smokers tend to

befriend smokers, and non-smokers befriend other non-smokers (Eiser et al., 1991).

• Increased levels of smoking are linked to peers’ encouragement and approval, together with the message that smoking promotes popularity (McAlister et al, 1984).

• Social learning theory (Bandura, 1977) – Behaviours are learned through the observation of others and subsequent modelling of this behaviour. Young people are most likely to imitate the behaviour of those with whom they have the most social contact. Once they have started smoking, experiences with the new behaviour determine whether it persists.

AO2/3 Research supports the claim

that exposure to peer models increases the likelihood that teenagers will begin smoking (Duncan et al., 1995).

There is support for the claim that perceived rewards such as social status and popularity are instrumental in why adolescents begin smoking and remain important while they continue to smoke (Eiser et al., 1989).

Peers-Social Identity Theory-

AO1• Abrams and Hogg, 1990• This assumes that group members

adopt those norms and behaviours that are central to the social identity of the group to which they belong.

• In peer groups where status as ‘smoker’ or ‘non-smoker’ is central to the social identity of the group, individuals are likely to be similar to one another in their smoking habits.

AO2/3 Although there is evidence to

support the claim that adolescents are motivated to begin smoking because of the stereotypes they hold of specific social crowds (Mitchell, 1997), little is known about the extent to which these groups influence their members to smoke.

We also don’t know whether adolescents are resistant to the demands of their social group when these conflict with their own concerns to maintain a healthy lifestyle.

Age

AO1• Prime time for the initiation of addiction is

adolescence. Those who start smoking earlier are less likely to be able to quit. Early dependency is also a ‘gateway’ to other addictive behaviours. Data from a Health Canada Youth Smoking Survey in 2006 compared smokers who became dependent aged 12-15 with non-smokers. They found that early-onset smokers were more likely to drink alcohol (91% compared to 52%), binge drink (58% compared to 23%) and smoke cannabis (50% compared to 5%). This supports the gateway explanation, supporting progression from legal to illegal drug use.

• There is also an increased vulnerability to addiction in old age, about a third of alcoholics develop their dependency after retirement. This could be linked to boredom, change in lifestyle of death of loved ones. Tranquilisers and sleeping tablet abuse have also been found to be problematic in elderly females.

AO2/3• Research has found that specific

initiatives for intervention would be much better if they were aimed at a particular age group. For example, opposing experimentation with cigarettes with young adolescents).

• Dependency in old age is a taboo subject. Older people are reluctant to admit or talk about their problems and addiction may be less evident. For example, taking addictive medication for old ladies is less visible than binge drinking teenagers. If younger people are more likely to admit they have problems then they are more likely to seek help and there is greater chance of intervention.

Personality-Neuroticism and Psychoticism-

AO1• Originally it was thought that addiction

changed your personality, but it is now more widely thought that your personality can lead to addiction. It could be that neurotic and psychotic people are more likely to turn to drugs to escape the painful reality of life.

• It has been suggested that there is an addictive personality. Eysenck (1997) outlined the psychological resource model which suggests that dependencies arise due to personality type. Individuals with high neuroticism (N), e.g. depression and anxiety, moodiness and irritability; and individuals with high psychoticism (P) e.g. hostile, impulsive, aggressive and emotional cold individuals are more vulnerable to addiction.

• It was also suggested by Eysenck that extraverts are chronically under-aroused and bored and so seek external stimuli to keep the brain aroused. This could also lead to addiction if seeking substances or gambling.

AO2/3 Belin et al. (2008) placed rats in a

device where they could self-administer doses of cocaine. One group of rats were sensation-seekers and started taking large doses. A second group were high in impulsiveness; they started with lower doses but they were the ones to become addicted. This shows that personality is a causal factor in addiction.

Buckholtz et al. (2010) suggest that people high in impulsivity and sensation-seeking have a more hypersensitive dopamine response system. They said that a heightened response to an anticipated reward could make such individuals less fearful about the consequences of their behaviour.

Practice Questions

1. Discuss the role of stress in the development of addition (4 + 4 marks)

2. Outline two risk factors in the development of addiction (4 marks)

3. Outline the role of personality in the development of addiction. Refer to research evidence in your answer (4 marks)

Discuss the role of stress in the development of addiction. (4 marks + 4 marks)

• Answer:AO1 – everyday stress (coping with daily hassles

contributes to initiation, maintenance and relapse – NIDA, 1999).

AO1 – traumatic stress (especially in children dealing with abuse or parental loss; and in adults PTSD has been linked to addiction).

AO2 – research support comes from PTSD in 30% of drug addicts and 15% of alcoholics.

AO2 – individual differences – Cloniger (1987) Type 1 drink to relieve tension and Type 2 drink to relieve boredom

Outline two risk factors in the development of addiction. (4 marks)• Answer:AO1 – sensation seeking (Zuckerman, 1983), and

extraversion (Eysenck, 1967)AO1 – peer pressure (smoking promotes

popularity – McAllister et al, 1984; modelling, social norms and social identity theory).

Outline the role of personality in the development of addiction. Refer to research evidence in your answer (4

marks)• Answer:AO1 – sensation seeking (Zuckerman, 1983)

linked to extraversion (Eysenck, 1967) to seek arousal

AO1 – addictive personality – Cloniger (1967) novelty-seeking, harm avoidance (pessimism), reward dependance

The Negative Role of the Media- FILMS -

AO1• Sulkunen (2007)

– 140 scenes, 47 films. 61 scenes analysed for addiction.– Films about drugs show drug competence and enjoyment of the

effects. Ordinary life was shown as dull.– The film ‘Human Traffic’ shows ecstasy being used to overcome

relationship problems.

• Waylen et al. (2011)– Examined 260 of the top US box office films from 2001-2005

• E.g. Bridget Jones’ Diary– Found that teenagers who watched these films where the actors

were smoking were more likely to start smoking themselves.– This was even after controlling for other social factors (parental

smoking)– There was a significant relationship between adolescent smoking

and the number of films watched

• Advertising can be used in 2 ways:– To encourage sales of tobacco, alcohol etc.– To promote health campaigns.

• Atkin et al. (1984) found that 12-17 year olds who had been exposed to higher levels of advertising were more likely to approve of under-age drinking and drunkenness.

• Charlton (1986) found that children who watched TV adverts with cigarettes thought that it made them look grown up and having confidence.

AO2/3

Sergent & Hanewinkel (2009) 4384 adolescents aged 11-15. Looking at smoking initiation. Found that of those who didn’t smoke and were exposed to movie smoking, it was a significant predictor of smoking a year later.

Boyd (2008) said films do represent drugs negatively; they show physical degradation (poor hair) and sexual degradation (prostitution). US movie writers are now given advice.

Byrne (1997) said people learn a lot from films, e.g. addicts from ‘Trainspotting’ and ECT from ‘One Flew over the Cuckoo’s Nest’.

The Positive Role of the Media- CHANGING ADDICTIVE BEHAVIOUR -

AO1• Psst…the really useful guide to alcohol

(1991) on the BBC. Those who watched the show had improved alcohol knowledge, but no attitude change.

• Kramer et al (2009) in the Netherlands found that there was a reduction in problem drinking after watching Drinking Less? Do it Yourself! a five week self-help intervention. Intervention group were more successful than a control group and this was maintained at 3-month follow-up.

• In 2008 Pablo the Dog was used to highlight what happens to drug carriers. You see the dog watch a young woman have a heart attack. The effectiveness of these campaigns is inconclusive.

AO2/3

Problems with the Kramer et al study:1. Intervention group had weekly visits –

so they got extra attention.2. The waiting lists group knew they would

get treatment so delayed behavior change so inflating the difference between the groups.

Drug campaigns don’t work because...1. Ideas aren’t novel so the effects are

minimal.2. Shows drugs as commonplace and so

there is a bad message.• Johnstone et al (2002) found that

films showed adolescents their peers were doing marijuana.

Planning an answer…Q. Discuss media influences on addictive behaviour (6 marks + 6

marks)A. AO1 –

AO1 – AO1 – AO2 – AO2 – AO2 –

Q. Use your knowledge of research into media influence on addictive behaviour to explain why films might encourage young people to start smoking. (6 marks)

R. AO2 – AO2 – AO2 –

Discuss media influences on addictive behaviour (6 marks + 6 marks)

• Answer:AO1 – drugs shown as a way of solving problems (Sulkunen,

2007).AO1 – Waylen et al. (2011) found that teenagers who watched

films where the actors were smoking were more likely to start smoking themselves.

AO1 – can be used to change behaviour (e.g. antidrug campaigns on TV and Pablo the dog).

AO2 – films have an affect on behaviour (Sargent and Hanewinkel showed the influence of movie smoking one year later).

AO2 – films do represent the negative consequences of drugs (Boyd, 2008 – prostitution, violence and moral decline).

AO2 – drug campaigns may have negative effects (Hornik et al, 2008) because they create peer norms (Johnston et al, 2002).

Use your knowledge of research into media influence on addictive behaviour to explain why films might encourage

young people to start smoking. (6 marks)• Answer:AO2 – role models and social learning theory

(Bandura, 1977). AO2 – Sargent and Hanewinkel (exposure to movie

smoking increased likelihood of smoking one year later)

AO2 – the media glamorises smoking (Gunasekera et al, 2005) as smoking is shown with no negative consequences. Waylen et al (2011) found that teenagers who watched films where the actors were smoking were more likely to start smoking themselves.

REDUCING ADDICTIVE BEHAVIOUR

The Theory of Planned Behaviour-Ajzen (1989)-

The Theory of Planned Behaviour

• A cognitive theory about the factors that lead to a person’s decision to engage in a particular behaviour.

• An individual’s decision to engage in a behaviour (e.g. to take drugs, or to give up alcohol) can be directly predicted by their intention to engage in that behaviour.

• Intention is a function of three factors:1. Behavioural attitude – A product of personal views; the individual’s attitude toward the

behaviour (i.e. how desirable it seems to be). This attitude is formed on the basis of beliefs about the consequences of performing the behaviour (e.g. I will feel good; I will get my life back together), and an appraisal of the value of these consequences (i.e. whether they will be good or bad).

2. Subjective norms – A product of social influence; the individual’s subjective awareness of social norms relating to that particular behaviour i.e. not simply social norms but the individual’s own beliefs about what we think significant others feel is the right thing to do (the ‘injunctive norm’) as well as perceptions of what other people are actually doing (the ‘descriptive norm’).

3. Perceived behavioural control is assumed to act either on the intention to behave in a particular way, or directly on the behaviour itself. This is because:a. The more control people believe themselves to have over the behaviour in question, the stronger their intention to actually perform that behaviour will be.b. An individual with higher perceived behavioural control is likely to try harder and to persevere for longer than someone with low perceived behavioural control.

How has the model been used to prevent addiction?

• Addiction to the sun:– White et al. (2008) 1000 participants aged 12-20 completed a questionnaire assessing the TPB

predictors. Two weeks later, participants reported their sun protection behaviour for the previous fortnight. Results showed that the three elements of the TPB were significant predictors of intentions to engage in sun protection, and these intentions were significant predictors of actual sun protection behaviour.

• Wilson and Kolander (2003) – Anti-drug campaigns often give adolescents actual data about the percentage of people

engaging in risky behaviour. This is done to change subjective norms. Adolescents who smoke are usually part of a peer group who smoke and might believe that smoking is the norm for teenagers. However, generally most adolescents do not smoke, so exposure to accurate statistical information should correct subjective norms and should form part of any effective campaign.

• Majer et al (2004)– Investigated the role of cognitive factors on abstinence. The TPB proposes that as part of

perceived behavioural control intentions will be stronger in people who have more self control. It was found that encouraging an addict’s belief in their ability to abstain was related to optimism and positive outcome. Therefore there is a need to enhance self-efficacy in treatment.

The Theory of Planned Behaviour-AO2-

The TPB is too rational and doesn’t take into account human emotions (Armitage et al., 1999).

The influence of alcohol or drugs can produce a discrepancy between intentions and actual behaviour. Attitudes and intentions are measured when sober, whereas risky behaviours such as gambling or unprotected sex may be performed when under the influence of alcohol or drugs. MacDonald et al. (1996) found that alcohol intoxication actually increased measured intention to engage in unprotected sex and other risky behaviours.

The TPB is normally assessed by questionnaires which may turn out to be poor representations of the attitudes and intentions that are actually performed, and thus poor predictors of actual behaviour (Albarracin et al., 2008). For example, a smoker may develop a negative attitude toward cigarettes based on their threat to his or her health, and intend to give them up. However, their actual intention and behaviour may differ greatly when they find themselves in a group of heavy smokers with all the associated sights and smells of smoking.

Research on the TPB is almost entirely correlational, linking positive (or negative) outcomes to certain behaviours. This means it is not clear that, for example, behavioural attitudes have caused any change.

Practice Question

Smoking is a major problem among young children and there are many campaigns to prevent young people from becoming addicted.Outline a strategy, based on the theory of planned behaviour, that could be used to prevent young people becoming addicted to smoking. (6 marks)

Types of Intervention- BIOLOGICAL -

AO1• Methadone

– Agonist substitution – a synthetic drug used to treat heroin addiction

– Mimics effects of heroin but is less addictive (removes withdrawal symptoms)

– Produces feelings of euphoria to a lesser degree– Prescribed a low dose, increase tolerance, then

decrease drug to wean off it• Drugs for gambling

– No legal drug in the UK– George and Murali (2005) suggest serotonin

dysfunction is involved in gambling addiction– Hollander et al (2000) gamblers were given SSRIs to

increase serotonin, significant improvements compared to a control group

– Naltrexone (dopamine receptor antagonist) works by reducing rewards of gambling

• Smoking treatments– Agonist substitution is used with nicotine

dependency. – Nicotine patches mimic or replace the effects of

nicotine. They may also desensitize nicotine receptors in the brain.

– They relieve withdrawal symptoms and stop cravings, patches are slowly reduced. The removal of withdrawal symptoms is an example of negative reinforcement.

– Treatment usually lasts 10-12 weeks.

AO2/3 Warren et al. (2005) assessed the effectiveness of

methadone as a treatment option among 900 inmates. Those prescribed methadone used heroin on average 15.24 days per year compared to 99.96 days per year for those not prescribed methadone. This shows that methadone is effective as a treatment for heroin addiction.

Some become just as reliant on methadone as heroin; substituting one addiction for another. Use of methadone is controversial, it was responsible for 300 deaths in the UK in 2007. There is also a black market, selling for £2

Hollander sample size was small (10 ppts) and a short duration (16 weeks). Blanco et al (2002) in a longer study (6 months) with 32 gamblers failed to find a link with SSRIs over a placebo.

Support for the use of naltrexone with gambling addiction comes from Kim and Grant (2001). After 6 weeks of treatment, gambling decreased significantly.

Moore et al. (2009) assessed the effectiveness of NRT finding them to be an effective intervention therapy. They achieved sustained abstinence in smokers who cannot or will not attempt immediate abstinence (quitting).

Types of Intervention- PSYCHOLOGICAL -

AO1• Reinforcement

– Sindelar et al (2007) used monetary rewards in a methadone treatment programme.

– Ppts were allocated to reward or no-reward condition.

– Both received care (methadone and counselling)

– When reward condition got a negative drug test they were entered into a draw for prizes.

– Negative samples were 60% higher than control group

• CBT– Change the way addiction is thought about

and learn new ways to cope effectively– For gambling, CBT aims to give patients

control and reduce cognitive errors, such as gamblers thinking that they can predict outcomes.

• Aversion therapy• An undesirable response to a particular

stimulus is removed by association of the stimulus with another, aversive, stimuli. Alcohol can be paired with an emetic drug, this induced vomiting so that vomiting becomes the conditioned response to alcohol. Between trials patients drink soft drinks so that generalisation does not occur. Aversion therapy can also occur with electric shocks.

AO2/3 Nothing is done to address the original problem.

When one addictive behaviour is reduced it can be replaced by something else instead.

Ladouceur et al (2001) randomly allocated 66 pathological gamblers to a CBT group or a waiting list group. Of those who had treatment, 86% no longer fit DSM criteria for pathological gambling, they also had better perception of self control and higher self-efficacy. Improvements were maintained at one year follow-up.

Sylvain et al (1997) evaluated the use of CBT with male gamblers. Also received social skills training and relapse prevention. Significant improvements were found, and maintained at one year follow-up

Meyer and Chesser (1970) found that 50% of alcoholics abstained for at least a year following treatment, and that aversion therapy was better than no treatment.

Types of Intervention- PUBLIC HEALTH INTERVENTIONS -

AO1• Quitline

– Stead et al (2006) meta-analysis of 18000 ppts found people who received regular calls from a counsellor increased odds of stopping smoking by 50% compared to self-help materials alone

• Worksite advice – ...comes on the basis of worksite bans

on smoking which came into place in 2007 when there was a new legal requirement.

– With worksite interventions there is the added bonus of social support and group intervention.

– The smoking ban means that there is an elimination of passive smoking, reduced risk of coronary heart disease and lung cancer.

AO2/3 Quitline was effective in reducing

nicotine dependence in soldiers returning from Iraq.

West (2009) showed that although there was a decline in the percentage of people smoking in the UK prior to the ban, there was a rebound effect. Attempts to stop smoking were greater in the 9 months before than the 17 months after the ban.

The Irish Office of Tobacco Control (2010) found that since the 2004 Irish smoking ban was put in place smoking prevalence fell from 26.4% to 23.6% suggesting the ban was effective.

However, after the initial drop the rate increased to 27.4% suggesting that the reduction could have been for economic reasons.

Planning an answer…Q. Outline one psychological intervention aimed at

reducing addiction. (4 marks)A. AO1 –

AO1 –

Q.Outline and evaluate one biological intervention aimed at reducing addiction. (4 marks + 4 marks)

R. AO1 – AO1 – AO2 – AO2 –

Outline one psychological intervention aimed at reducing addiction. (4 marks)Answer: AO1 – reinforcement (Sindelar et al., 2007) the

use of monetary rewards in a methadone treatment programme

AO1 – found that negative urine samples were 60% higher than in the control group of methadone and counselling alone

Outline and evaluate one biological intervention aimed at reducing addiction. (4 marks + 4 marks)

• Answer: AO1 – methadone is used for heroin addiction. A

synthetic drug which mimics the effects of heroin to a lesser degree.

AO1 – given in increasing amounts to increase tolerance and then decreased.

AO2 – some become just as reliant on methadone as heroin; substituting one addiction for another.

AO2 – use of methadone is controversial, it was responsible for 300 deaths in the UK in 2007. There is also a black market, selling for £2