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Encyclopedia
A
- ADHD and Addiction
- Subtopic 1: ADHD Across Life
- Subtopic 2: How ADHD and Substance Use Can Intersect
- Subtopic 3: When the Picture Is Unclear
- Subtopic 4: Attention, Sleep and Changing Substance Use
- Subtopic 5: Care for ADHD and Addiction
- Subtopic 6: Medicines Without Myths
- Subtopic 7: Support That Fits Daily Life
- Subtopic 8: Partners, Families and Shared Responsibilities
- Subtopic 9: Understanding the Evidence
- Acamprosate
- Addiction
- What Makes Addiction Different From a Habit?
- How Addiction Can Narrow Choice
- How Learning, Reward and Relief Help Maintain Addiction
- Why Some People Are More Vulnerable Than Others
- Addiction, Physical Dependence, Tolerance, Withdrawal and Cravings
- Intoxication Is Not the Same as Addiction
- Substance Use Disorder: The Clinical Language
- Addiction Does Not Look the Same for Everyone
- Harm, Responsibility and Stigma
- Treatment, Harm Reduction and Recovery
- Advanced Depth: How Addiction Emerges Across Brain, Learning and Environment
- Addiction Vulnerability and Protective Factors
- Addiction and the Justice System
- Recognising Health Needs at Each Point of Contact
- Urgent Illness Must Not Be Treated as Misconduct
- Treatment in Custody and Community Supervision
- Communication, Disability and Fair Participation
- Unequal Contact and Access to Support
- Continuity of Care When Returning to the Community
- Family, Community and People Harmed
- Advanced Depth: Evaluating Institutional Responses
- Alcohol
- Alcohol in Plain Sight
- What Alcohol Does to the Brain
- From Drinking to Adaptation, Tolerance and Dependence
- Alcohol and the Body
- Alcohol, Mood, Anxiety and Sleep
- Alcohol, Hallucinations and Psychosis
- Alcohol and Medicines or Other Drugs
- Withdrawal: When Stopping Alcohol Can Be Dangerous
- Recovery: More Than Stopping Drinking
- Advanced Science: Neuroadaptation, Dependence and Clinical Complexity
- Alcohol Use Disorder (AUD)
- What Makes Drinking an Alcohol Use Disorder?
- How AUD Can Show Up in Everyday Life
- How AUD Is Diagnosed: The 11 DSM-5-TR Criteria and Severity
- AUD, Heavy Drinking, Addiction and Physical Dependence
- Why AUD Develops Differently in Different People
- AUD and Other Health or Mental Health Problems
- Recognising AUD and Clinical Assessment
- Treatment and Recovery From AUD
- Stopping Alcohol Safely When Dependence May Be Present
- Advanced Depth: Diagnosis, Classification and Clinical Complexity
- Alprazolam (Xanax)
- Amphetamines
- 1. Amphetamines: Medicines, Misuse and Different Contexts
- 2. What Amphetamines Feel Like and Why People Use Them
- 3. What Amphetamines Do in the Brain
- 4. Methamphetamine: A Major Member of the Amphetamine Family
- 5. Repeated Use, Craving and Stimulant Use Disorder
- 6. Sleep, Appetite and the Stimulant Crash
- 7. Cardiovascular, Temperature and Neurological Risks
- 8. Anxiety, Paranoia and Psychosis
- 9. Treatment and Recovery From Amphetamine Problems
- 10. Advanced Science: Release, Transporters, Sensitisation and Clinical Complexity
- Anxiety
- Ordinary anxiety and anxiety disorders
- Panic and the effects of avoidance
- Substance effects and the search for relief
- Withdrawal, rebound and returning symptoms
- When anxiety needs urgent help
- Assessment when explanations overlap
- Treatment and support for both needs
- Anxiety during change and everyday life
- Family and supporter experience
- Optional professional depth: interpreting course and evidence
- Attention and Concentration
B
- Baclofen
- Benzodiazepines
- 1. Benzodiazepines: Useful Medicines With Important Limits
- 2. Calm, Sedation and What Benzodiazepines Feel Like
- 3. How Benzodiazepines Work in the Brain
- 4. Tolerance, Physical Dependence and Why They Are Not Addiction
- 5. Withdrawal: Why Stopping Suddenly Can Be Dangerous
- 6. Alcohol, Opioids and Other Sedatives
- 7. Memory, Falls, Driving and Everyday Functioning
- 8. Different Benzodiazepines, Different Time Courses
- 9. Prescribing, Deprescribing and Recovery
- 10. Advanced Science: GABA-A Modulation, Pharmacokinetics and Withdrawal Complexity
- Brain
- Brain and Body Recovery
- Buprenorphine
C
- Cancer and Substance Use
- Risk Does Not Explain One Person's Cancer
- Alcohol and Cancer Risk
- Tobacco, Nicotine and Vaping
- Other Substances, Infections and Uncertain Evidence
- Reducing Risk and Getting Checked
- Substance Use During Cancer Treatment
- Pain Relief, Dependence and Addiction Care
- Living With Cancer: Disclosure, Support and Access
- Evidence and Coordinated Care
- Cannabis
- 1. Cannabis Is Not One Product
- 2. THC, CBD and the Endocannabinoid System
- 3. Intoxication: Perception, Memory, Attention and Coordination
- 4. Route, Potency and Why Effects Can Be Hard to Predict
- 5. Anxiety, Paranoia and Psychosis
- 6. Repeated Use, Tolerance, Dependence and Cannabis Use Disorder
- 7. Cannabis, Age and the Developing Brain
- 8. Medical Cannabis and CBD: Evidence, Claims and Uncertainty
- 9. Synthetic Cannabinoids: Not Simply Stronger Cannabis
- 10. Treatment and Recovery From Cannabis Problems
- 11. Advanced Science: Cannabinoid Signalling, Potency and Evidence Complexity
- Carbamazepine
- Clonidine
- Cocaine
- 1. Cocaine and Crack: The Same Drug in Different Forms
- 2. What Cocaine Feels Like and Why It Can Be Repeated Quickly
- 3. What Cocaine Does in the Brain
- 4. Craving, Binge Patterns and Cocaine Use Disorder
- 5. Cocaine and the Heart and Circulation
- 6. Cocaine, Stroke and Seizures
- 7. Anxiety, Paranoia and Psychosis
- 8. Alcohol, Fentanyl and Other Drug Combinations
- 9. Treatment and Recovery From Cocaine Problems
- 10. Advanced Science: Transporters, Cardiovascular Toxicity and Clinical Complexity
- Counselling
- The therapeutic relationship
- Starting, goals and uncertainty about change
- Psychological Approaches to Addiction Care
- Individual, group and family participation
- Fit, competence and accessible participation
- Confidentiality, Documentation and Professional Boundaries
- Counselling alongside medical and safety needs
- Evidence, progress and professional judgement
- Cravings
- What a Craving Can Feel Like
- Where Cravings Come From
- Cues, Context and Craving
- Wanting Is Not the Same as Liking
- Craving for Relief
- Cravings During Withdrawal and Early Recovery
- Why Cravings Can Return After a Long Time
- Craving Does Not Equal Relapse
- When Cravings Become Especially Difficult
- Advanced Depth: Incentive Salience, Cue Reactivity and Motivational Control
D
- Death
- Palliative care and approaching the end of life
- When addiction and serious illness need care together
- Pain medicines, comfort and recovery
- Dependence and withdrawal still matter
- Agency, communication and care decisions
- Relationships without forced reconciliation
- Comfort and care in the last days
- Dignity when care is difficult to reach
- Advanced depth: uncertainty and clinical judgement
- Depression
- Sadness, Grief and Depressive Disorder
- Loss of Interest, Numbness and Daily Life
- Substance Use and Changing Mood
- Assessment and Other Explanations
- Care for Depression and Substance Use
- Small Steps Without Blame
- Family, Friends and Supporters
- Safety and Getting Help
- Professional Depth: Causes, Measurement and Evidence
- Disulfiram
- Domestic Abuse and Safety
- Dopamine
- Dreams
- Driving
- Dual Diagnosis
- Understanding Co-occurrence
- Assessment When the Cause Is Uncertain
- Psychosis and Substance Use
- Bipolar Disorder and Substance Use
- OCD and Substance Use
- Personality Disorders and Substance Use
- Eating Disorders and Substance Use
- Integrated Care in Practice
- Family and Supporters
- Optional Professional Depth: Formulation and Evidence
E
- Early Recovery and Stabilisation
- Ecstasy (MDMA)
- 1. MDMA and Ecstasy Are Not Exactly the Same Thing
- 2. What MDMA Feels Like and Why People Use It
- 3. How MDMA Changes Serotonin, Norepinephrine and Dopamine
- 4. Heat, Dancing and Hyperthermia
- 5. Water, Sodium and Why Too Much Fluid Can Also Be Dangerous
- 6. Strength, Adulteration and an Uncertain Drug Supply
- 7. Other Drugs, Medicines and Serotonin Toxicity
- 8. The Days After MDMA: Sleep, Mood and Energy
- 9. Repeated Use, Tolerance and Problematic Patterns
- 10. Treatment, Recovery and When MDMA Use Becomes a Problem
- 11. MDMA in Therapy: A Different Context
- 12. Advanced Science: Monoamine Transporters, Thermoregulation and Toxicity
- Emotions and Substance Use
- Using to Change a Feeling
- How Relief Becomes a Learned Response
- Emotional Changes During and After Use
- Anger, Rage and Frustration
- Regret, Guilt and Accountability
- Aggression and Substance Use
- Making Room for a Different Response
- Other People's Feelings and Needs
- Advanced Depth: Emotion, Learning and Evidence
- Environment
- Material Resources and Everyday Opportunity
- Housing and Homelessness
- Rural Access, Transport and Digital Barriers
- Disability, Communication and Language Access
- Racism, Discrimination and Structural Inequity
- Culture, Community and Participation in Care
- Availability, Marketing, Education and Policy
- School, Work and Community Settings
- Advanced Depth: Interpreting Environmental Evidence
F
- Faith and Spirituality in Recovery
- Family
- Different Relationships, Different Effects
- Family Members' Own Support and Boundaries
- Parenting During Substance Use and Recovery
- Children Affected by Parental Addiction
- Child Safeguarding
- Communication, Trust and Different Timetables
- Participation in Care, Consent and Confidentiality
- Whānau, Culture and Who Belongs
- Advanced: Family Systems and Evidence for Family Support
- Fear
- Fetal Alcohol Spectrum Disorder (FASD)
- Recognising Needs Without Assuming a Diagnosis
- What Assessment Tries to Understand
- When Expectations Exceed Everyday Capacity
- Communication and Learning That Fit
- Health, Substance Use and Accessible Care
- Adulthood, Choice and Participation
- Family and Supporter Needs
- Advanced Depth: Diagnosis and Evidence for Support
- Finding Addiction Care
- Forgiveness
- Frontal Lobe Damage from Alcohol
- Temporary impairment, persistent difficulty and injury
- When knowing a plan and carrying it out diverge
- Alcohol-related brain damage and overlapping causes
- Understanding what an assessment can establish
- Recovery without a fixed timetable
- Support, participation and responsibility
- Professional depth: interpreting executive impairment
G
- GABA
- GABA and Glutamate: Keeping Neural Activity in Balance
- Alcohol, GABA and the Adapted Brain
- Withdrawal: When the Nervous System Becomes Overactive
- GABA, Sleep, Anxiety and Arousal
- GABA Works in Networks, Not Alone
- Can You Boost GABA? Foods, Supplements and Lifestyle Claims
- Medicines and Drugs That Affect GABA Signalling
- Neurobiology and Clinical Detail
- Gabapentin
- Gait & Alcohol Effects
- Gambling
- Gaming Addiction
- Gardening & Mental Health
- Genetics & Vulnerability
- Glutamate
- 1. Excitation Needs Regulation
- 2. Learning, Memory and Substance-Related Cues
- 3. Alcohol and an Adapting Nervous System
- 4. Why Alcohol Withdrawal Can Become Dangerous
- 5. Hyperexcitability and Excitotoxicity Are Different
- 6. Glutamate in Food, Glutamine and Brain Signalling
- 7. What Symptoms and Recovery Can Tell Us
- 8. Advanced Depth: Receptors, Recycling and Interpreting Evidence
- Grey Matter & Structural Brain Changes
- Grief
- Growth
H
- HPA Axis (Stress System)
- Hallucinations
- Haloperidol
- Psychotic Symptoms, Acute Distress and the Treatment Question
- Alcohol Withdrawal and Delirium: An Additional Role
- Restlessness, Stiffness and Involuntary Movements
- Heart Rhythm and Other Serious Safety Concerns
- Understanding the Plan After an Acute Episode
- Advanced Depth: Dopamine Targets and Clinical Outcomes
- Harm Reduction
- What Harm Reduction Means
- Harm Reduction and Abstinence Are Not Opposites
- Meeting People Where They Are
- Reducing Overdose and Poisoning Risk
- Reducing Infection and Other Health Risks
- Engagement, Trust and Access to Care
- Harm Reduction as a Route Into Treatment and Recovery
- Harm Reduction Across Different Goals
- What Harm Reduction Cannot Do
- Harm Reduction, Families and Communities
- Advanced Depth: Evidence, Ethics and Public-Health Practice
- Head Injury & Concussion
- What a concussion is
- When an injury needs urgent help
- Alcohol, falls and overlapping symptoms
- Memory gaps, unconsciousness and seizures
- Assessment and what scans can show
- Thinking, feeling and everyday function
- Recovery and continuing difficulties
- Family and supporter experience
- Mechanisms, repeated injury and limits of evidence
- Heart
- Heart Rhythm and Palpitations
- Blood Pressure, Blood Vessels and Stroke
- Heart Muscle and Heart Failure
- Different Substances, Different Cardiovascular Risks
- Withdrawal and Cardiovascular Strain
- When Symptoms Need Urgent Help
- Assessment and Coordinated Care
- Living With Heart Problems: Daily Life and Family
- Professional Depth: Mechanisms, Causation and Clinical Interpretation
- Hippocampus
- Hormones and Substance Use
- How Hormone Signals Work
- Alcohol and Endocrine Function
- Opioids and Reproductive Hormone Suppression
- Metabolism, Stress and Interacting Systems
- Reproductive Changes and Life Stage
- Discussing Changes and Interpreting Tests
- Energy, Sexual Wellbeing and Relationships
- Hormone Explanations in Recovery
- Advanced Depth: Endocrine Findings and Clinical Meaning
- Human Body Impact
I
- Identity
- Illness
- Illness, Function and the Search for Relief
- Invisible Illness, Disbelief and Isolation
- Medicines, Substance Use and Coordinated Care
- Recovery While Illness Continues
- Families, Supporters and Their Own Needs
- New Confusion and Other Causes of Delirium
- Professional Depth: Assessment Without a Single-Cause Story
- Impulsivity
- In-Laws
- Infections and Substance Use
- Routes of Vulnerability
- Infection Prevention, Testing and Care
- HIV and Substance Use
- Viral Hepatitis and Substance Use
- Skin, Wounds and Deeper Infections
- Recognising Illness and Getting Help
- Substance Use During Infection Care
- Stigma, Access and Support
- Professional Depth: Exposure, Susceptibility and Integrated Care
- Inflammation
- Protective Responses and Persistent Inflammation
- Alcohol, Other Substances and Immune Function
- The Gut, Tissue Barriers and Immune Signals
- Immune Activity in the Brain
- Bloating, Fatigue and Symptoms That Need Assessment
- What Inflammation Tests Can Tell Us
- Care, Recovery and Treatment Claims
- Understanding Symptoms Together
- Professional Depth: Evidence, Measurement and Clinical Interpretation
- Inner Dialogue and Thinking Patterns
- Ordinary Self-Talk and Perceived Voices
- Ambivalence and Substance-Related Thoughts
- Thoughts, Interpretations and Evidence
- Rumination, Worry and Intrusive Thoughts
- Self-Criticism, Accountability and Perspective
- Relating Differently to Thoughts in Recovery
- Families, Friends and Conversations
- Scientific and Professional Perspective
- Internet
- Intimacy
J
K
- Ketamine
- 1. Ketamine: One Drug, Very Different Contexts
- 2. Dissociation: What Ketamine Can Feel Like
- 3. How Ketamine Changes Glutamate Signalling
- 4. Acute Impairment, Accidents and Loss of Awareness
- 5. Alcohol, Opioids and Other Sedatives
- 6. Ketamine and the Bladder: A Distinctive Long-Term Harm
- 7. Abdominal Pain, Liver and Biliary Problems
- 8. Memory, Attention and Repeated Use
- 9. Tolerance, Craving and Ketamine Use Disorder
- 10. Treatment and Recovery From Problematic Ketamine Use
- 11. Ketamine and Esketamine in Mental-Health Treatment
- 12. Advanced Science: NMDA Antagonism, Plasticity and Organ Toxicity
- Kindling Effect
L
- Learning and Habit Change
- How Substance-Related Behaviour Is Learned
- Cues, Context and Learned Associations
- What Makes a Behaviour a Habit?
- Repetition, Routine and Automaticity
- Goal-Directed and Habitual Control Can Coexist
- When Old Responses Conflict With New Goals
- Extinction: Learning Something New Rather Than Erasing the Past
- Why Old Responses Can Return
- Changing Cues, Routines and Responses
- Making New Learning Work Across Different Situations
- Advanced Depth: Habit Models, Extinction, Renewal and Reacquisition
- Legal Consequences
- Liver
- Subtopic: What the Liver Does
- Subtopic: Fatty Change, Inflammation and Scarring
- Subtopic: Alcohol-Associated Liver Disease
- Subtopic: Other Causes and Substance-Related Injury
- Subtopic: Serious Liver Illness
- Subtopic: Understanding Tests and Assessment
- Subtopic: Changing Substance Use and Ongoing Liver Care
- Subtopic: Living With Liver Problems: Daily Life and Family
- Subtopic: Professional Depth: Injury, Fibrosis and Clinical Interpretation
- Looks
- Skin changes and alcohol
- Sleep, nutrition and changes in the body
- When visible changes need health care
- Appearance and recovery
- Visibility, shame and other people's assumptions
- Talking about changes with family and friends
- Seeking care without a makeover requirement
- Advanced depth: why appearance is a weak health measure
- Loss
- Love
M
- Management
- Useful Structure Without a Perfect Routine
- Boredom and Unstructured Time
- Television and the Paired Drinking Routine
- Tea and Changing One Part of a Ritual
- Observe, Try and Review Without Requiring Writing
- Plans That Allow for Other People and Changing Circumstances
- Advanced: Function, Fit and the Limits of Self-Management
- Marriage
- How Alcohol Problems Strain a Marriage
- What Happens to the Other Partner
- Trust, Boundaries and Responsibility
- Recovery as a Relationship Process
- When the Relationship Cannot Simply Return to "Normal"
- Safety, Fear and When Outside Help Matters
- Relationship Dynamics, Couple Recovery and Clinical Considerations
- Medicines
- Meditation
- Memory
- Mental Health
- Methadone
- Money
- Motivation
- Movement
- Music
N
- Naltrexone
- Neuroplasticity
- Nicotine, Tobacco and Vaping
- 1. Nicotine, Tobacco and Vaping Are Related but Not the Same Thing
- 2. What Nicotine Feels Like and Why Use Can Become Repetitive
- 3. How Nicotine Changes Reward, Attention and Learning
- 4. Cigarettes and Combustion: Why Smoking Is So Harmful
- 5. Vaping: Lower Risk Than Smoking Does Not Mean Harmless
- 6. Youth, Nicotine and the Developing Brain
- 7. Dependence, Withdrawal and the Cycle of Relief
- 8. Smoking, Vaping and Everyday Life
- 9. Quitting Smoking, Quitting Vaping and Treating Nicotine Dependence
- 10. Harm Reduction, Switching and Dual Use
- 11. Advanced Science: Nicotinic Receptors, Delivery Kinetics and Comparative Harm
- Nutrition
O
- Obsession
- Office
- Olanzapine
- Older Adults and Substance Use
- Recognising Problems Without Assuming Age Is the Cause
- Changing Health, Falls and Alcohol Effects
- Medicines, Interactions and Physical Dependence
- Retirement, Loss and Changing Daily Life
- Finding Care That Fits the Person
- Supporting Independence, Relationships and Recovery
- Advanced Depth: What Age-Specific Treatment Evidence Can Tell Us
- Opioids
- 1. Opioids: One Drug Class, Very Different Contexts
- 2. Pain Relief, Pleasure and Relief From Distress
- 3. What Opioids Do to the Brain and Body
- 4. Tolerance, Physical Dependence and Withdrawal
- 5. Opioid Use Disorder, Craving and Repeated Use
- 6. When Opioids Slow Breathing Too Much
- 7. Fentanyl, Potency and an Uncertain Drug Supply
- 8. Mixing Opioids With Alcohol, Benzodiazepines and Other Drugs
- 9. Treatment and Recovery
- 10. Advanced Science: Receptors, Potency and Clinical Complexity
- Overconfidence
- Overdose and Poisoning
- What Overdose and Poisoning Mean
- Recognising a Medical Emergency
- Breathing and Consciousness: Why They Matter
- Opioid Overdose and Naloxone
- Mixed Substances and Combined Effects
- Poisoning and Unknown or Counterfeit Substances
- Aspiration, Vomiting and Breathing Emergencies
- Severe Agitation, Delirium, Violence and Immediate Danger
- After Apparent Recovery
- Accidental, Intentional and Uncertain Exposure
- Advanced Depth: Toxic Syndromes, Mixed Exposure and Emergency Assessment
P
- PAWS
- PTSD & Drinking to Cope
- Pain and Substance Use
- Acute and chronic pain
- When relief becomes part of substance use
- Prescribed opioids and pain care
- Tolerance, dependence and addiction
- Pain during withdrawal and treatment changes
- Treating pain and addiction together
- Pain that is difficult to explain or believe
- Function, family and recovery
- Advanced depth: pain mechanisms and clinical uncertainty
- Peer Pressure
- Perimenopause and Alcohol Cravings
- Peripheral Nerves and Autonomic Function
- Sensation, Strength and Automatic Regulation
- Peripheral Neuropathy and Its Different Causes
- Alcohol, Nutrition and Nerve Injury
- When Automatic Functions Become Difficult
- Nitrous Oxide and Neurological Harm
- Getting Symptoms Assessed
- Daily Life, Safety and Support
- Recovery Without a Fixed Timetable
- Advanced Depth: Nerve Fibres, Tests and Evidence
- Physical Dependence
- What Physical Dependence Means
- How the Body Adapts to Repeated Exposure
- Physical Dependence Is Not the Same as Addiction
- Physical Dependence, Tolerance and Withdrawal
- When Dependence Develops During Medical Treatment
- Why Dependence and Withdrawal Differ Between Substances
- Reducing or Stopping When Physical Dependence May Be Present
- Advanced Depth: Adaptation, Homeostasis and Dependence
- Polysubstance Use
- 1. Polysubstance Use Is More Than “Mixing Drugs”
- 2. Why Drug Effects Do Not Simply Add Up
- 3. Alcohol, Benzodiazepines, Opioids and Other Depressants
- 4. Stimulants and Depressants: Why They Do Not Cancel Each Other
- 5. Stimulant–Opioid Combinations
- 6. Sequential Use: Using One Drug to Manage Another
- 7. Unknown Contents, Counterfeit Pills and Unintentional Exposure
- 8. Overdose When More Than One Drug Is Involved
- 9. Dependence and Withdrawal From More Than One Substance
- 10. Mental Health, Sleep and the Push-Pull Cycle
- 11. Treatment and Recovery From Polysubstance Use
- 12. Advanced Science: Interaction Mechanisms, Toxicity and Clinical Complexity
- Prefrontal Cortex
- Keeping Goals in Mind and Changing Direction
- Judgement, Emotion and What Matters Now
- Alcohol, Other Substances and Different Kinds of Change
- When an Intention Is Hard to Carry Out
- Development Without a Birthday Switch
- Recovery and Making Daily Demands Manageable
- Advanced Depth: Networks, Tests and Interpretation
- Pregnancy, Postpartum and Substance Use
- Prenatal Alcohol Exposure and Development
- Psychology of Addiction
- What Psychology Adds to Understanding Addiction
- Why People Use: Motives Can Differ and Change
- Expectations, Beliefs and Substance Use
- Emotion Regulation and Using to Change How You Feel
- Attention and Automatic Cognitive Bias
- Immediate Rewards, Future Consequences and Decision-Making
- Automatic and Reflective Processes
- Impulsivity, Self-Control and Executive Function
- Self-Efficacy: Believing You Can Respond Differently
- Psychological Change During Recovery
- Advanced Depth: Cognitive-Affective Models, Decision-Making and Behavioural Control
Q
R
- Recovery
- What Recovery Means
- Recovery Does Not Look the Same for Everyone
- The Many Dimensions of Recovery
- Recovery Capital
- Education and Knowledge in Recovery
- Relationships, Trust and Social Connection
- Practical Stability: Home, Money and Daily Life
- Purpose, Identity and Meaningful Activity
- Continuing Care and Coordinated Support
- Recovery After Setbacks or Recurrence
- Recovery for Families and Supporters
- Advanced Depth: Recovery Models, Capital, Outcomes and Systems of Care
- Reinforcement
- What Reinforcement Means
- Positive Reinforcement: When an Effect Makes Use More Likely
- Negative Reinforcement: When Relief Strengthens Behaviour
- Negative Reinforcement Is Not Punishment
- Why Immediate Effects Can Outweigh Distant Consequences
- Cues, Context and Reinforced Behaviour
- Why Substance Use Can Continue After the Pleasure Fades
- Reinforcement, Withdrawal and Craving
- Reinforcement Does Not Remove Choice or Responsibility
- Changing What Is Reinforced During Recovery
- Advanced Depth: Reinforcement Learning, Prediction Error and Addiction
- Relapse
- What Relapse Means
- Relapse Is Possible, Not Inevitable
- Relapse Usually Has More Than One Cause
- Craving and Triggers Increase Risk but Do Not Decide the Outcome
- When Risk Builds Gradually, and When It Does Not
- One Episode Does Not Have to Become a Full Return
- Safety After a Return to Use
- What a Relapse Can Tell Us
- Relapse, Families and Trust
- Returning to Recovery After Relapse
- Advanced Depth: Relapse Models, Prediction and Clinical Response
- Relationships & Responsibility
- Residential Rehabilitation and Treatment Choices
- Resilience
- Reward
- What Reward Means
- Reward Is Not the Same as Reinforcement
- Liking, Wanting and Learning
- When Wanting Becomes Stronger Than Liking
- How Cues Gain Motivational Power
- Reward Learning and Prediction
- Why Substance Rewards Can Dominate Attention and Choice
- Reward, Pleasure and Tolerance
- Reward, Craving and Motivation
- Reward During Recovery
- Advanced Depth: Reward Circuits, Incentive Salience and Prediction Error
S
- Seizures
- Seizures and getting medical help
- What a seizure means
- Alcohol withdrawal and repeated withdrawals
- Toxic exposure, medicines and other illness
- Head injury, epilepsy and uncertainty about cause
- What medical assessment can clarify
- Living after a seizure
- Families and supporters
- Advanced depth: acute symptomatic seizures and enduring risk
- Self-Harm
- Sex
- Consent, Capacity and Responsibility
- Desire, Inhibition and Physical Responses
- Sexual Health and Dysfunction
- Compulsive Sexual Behaviour
- Sexual Choices During Recovery
- Respectful Care Across Identities and Experiences
- After Coercion, Assault or an Unsafe Encounter
- Advanced Depth: Symptoms, Screening and Clinical Formulation
- Shame & Social Withdrawal
- Sleep
- 1. Sleep Pressure, Body Clocks and Sleep Stages
- 2. Alcohol and Other Substances
- 3. Insomnia and the Effort to Sleep
- 4. Sleep When Substance Use Changes
- 5. Sleep Disorders and Medical Assessment
- 6. Sleep, Perception and Night-Time Events
- 7. Sleep Care and Medicines
- 8. Routines, Constraints and Support
- 9. When Sleep Problems Need Urgent Help
- 10. Professional Depth: Measurement, Mechanisms and Treatment Evidence
- Social Life (Without Drinking)
- Social Media
- Stigma and Judgement
- Stress & Sensitivity
T
- Teeth
- Dry mouth and the work of saliva
- Decay and acid erosion are different
- Gums, tobacco and oral tissues
- Grinding, clenching and jaw discomfort
- Different substances, different contexts
- Dental care alongside addiction treatment
- Pain, assessment and getting through the appointment
- Daily care and recovery without a perfect smile
- Advanced depth: interpreting oral-health evidence
- Tolerance
- What Tolerance Means
- How Tolerance Develops
- Functional and Metabolic Tolerance
- Learned and Context-Dependent Tolerance
- Tolerance Does Not Mean Protection From Harm
- Cross-Tolerance
- Tolerance, Physical Dependence and Addiction
- When Tolerance Decreases
- Tolerance Is Not Sensitisation
- Advanced Depth: Pharmacokinetic, Pharmacodynamic and Learned Adaptation
- Topiramate
- The alcohol-treatment role and off-label meaning
- Thinking, communication and everyday responsibilities
- Other unwanted effects and urgent recognition
- Pregnancy-related risk and a planned clinical conversation
- Reviewing benefit, burden and treatment changes
- Mechanisms, trial outcomes and individual tolerability
- Trauma & The Brain
- Trauma Exposure, Responses and PTSD
- Threat Learning and Bodily Readiness
- Reminders, Attention and Memory
- Feeling Numb or Disconnected
- Trauma, Substance Use and Relief
- Recovery Without a Brain-Repair Promise
- Friends, Family and Understanding
- Choice and Trauma-Informed Care
- Research: What Brain Changes Can and Cannot Tell Us
- Triggers
- Truth
U
V
W
- Wernicke Encephalopathy and Korsakoff Syndrome
- Recognising Wernicke Encephalopathy
- Why Thiamine Deficiency Can Harm the Brain
- Distinguishing the Conditions and Other Causes
- Korsakoff Syndrome, Memory and Confabulation
- Urgent Treatment and Continuing Care
- Living With Memory Difficulties
- Supporting Someone and Shared Daily Life
- Advanced Depth: Assessment, Brain Systems and Evidence
- Why Me?
- Willpower
- Withdrawal
- What Withdrawal Means
- Why Withdrawal Symptoms Occur
- Withdrawal Is Different for Different Substances
- When Withdrawal Can Become Dangerous
- Why Previous Withdrawal History Matters
- Withdrawal, Craving and the Drive to Use Again
- Withdrawal During Prescribed Treatment
- Acute Withdrawal and Persistent Symptoms
- Withdrawal Management Is Not Addiction Treatment
- Advanced Depth: Neuroadaptation, Withdrawal Severity and Repeated Withdrawal
- Women & Alcohol
- Sex-Related Differences in Alcohol Exposure
- Alcohol-Related Health Risks and Recognition
- Stress, Expectations and Barriers to Care
- Menstrual Cycle and Cravings
- Premenstrual Dysphoric Disorder (PMDD)
- Reproductive Transitions and Changing Needs
- Care That Takes the Whole Person Seriously
- Advanced Depth: Separating Biology, Experience and Evidence
X
Y
- Youth
- Development, Decisions and Learning
- Recognising Problems and Taking Safety Seriously
- Peers, School and Belonging
- Mental Health and Substance Use Together
- Family and Youth Prevention
- Care That Fits a Young Person's Needs
- Recovery While Life Keeps Changing
- Moving Between Youth and Adult Services
- Advanced Depth: Reading Youth Evidence Carefully
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