Chapter #13: Alcohol-Drug Treatment Program Presented By: Rose Aldan RH320-01

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1 Chapter #13: Alcohol-Drug Treatment Program Presented By: Rose Aldan RH320-01

2 Classroom Norms Cell phones on silent or vibrate Respect Others Be willing to participate Have FUN Learning

3 Student Learning Outcomes (SLO s) By the end of Chapter 13 students will be able to Understand and retain the four pivotal events prior to Describe the History of Alcohol-Drug Treatment Programs. Comprehend how medicine plays a significant role in addiction treatment. Be aware of the two major influences on modern treatment. Recognize Legislation, Authority and Funding or Treatment Centers. Know the different kinds of Client Services.

4 Bellwork What do you think about the usage of drug and alcohol here in the CNMI and why do you think that there is such a high rate of people who are addicted drugs and alcohol? Be ready to share

5 History In 1784, Benjamin Rush (who is considered a significant figure in the evolution of thinking about alcoholism) suggested that chronic drunkenness was a progressive medical condition that could be arrested by abstinence. Common views of addictive behavior through the years characterized it as a moral problem and judged addicted individuals to be evil, morally weak, or possessed by evil spirits. Between the 1790 s-1830 s Americans average alcohol consumption tripled and the resulting public drunkenness and related problems raised new concerns among many about the country s drinking practices, which eventually led to different efforts to control it. Cultural views of alcoholism, addiction, and more recently, scientific research have all influenced treatment throughout the decades.

6 Four Pivotal Historical Events In the history of addiction treatment and recovery in America, William White (1998) noted that there were four pivotal events prior to The initial event was the emergence of the first addiction treatment centers known as inebriate homes and asylums. The second event was the drug prohibition movement in the United States, led by Carrie Nation and the Women s Christian Temperance Union, which sought a legal cure to alcoholism by initiating prohibition. With this, the Harrison Tax Act of 1914 was passed to regulate and tax the production, importation, distribution, and use of opiates. The third event was the founding of Alcoholics Anonymous (AA) in The fourth milestone was the opening of two narcotic treatment farms in the mid-1930 s by the federal government, marking the beginning of its direct involvement in addiction treatment.

7 Activity Time Which came first, the chicken or the egg?!? On your marks, get set, GO!!!!!

8 History (Continued) Alcoholics Anonymous was founded in 1935, when two alcoholics began to help one another. Meeting in small groups, AA s members strive to attain abstinence from alcohol as they work together through the twelve step program. The small beginning of AA has since led to the establishment of local groups all over the world, composed of addicts who offer each other mutual aid and support. Another movement was led by Marty Mann, who established the National Council on Alcoholism in 1944 after undergoing her own recovery from alcoholism.

9 Another recovering individual founded a treatment approach in the late 1950 s that came to be known as Synanon. Originally, the Synanon community included both alcoholics and drug addicts, but later primarily targeted drug addicts. The Synanon marked the birth of ex-addict-directed therapies. One in particularly called Therapeutic Communities (TC), many of which are still in existence today. Although TC has evolved over the years, the underlying goal is having community member attain abstinence and re-enter society as productive member. Traditionally, these programs have fairly lengthy periods of stay (greater than one year) and many of the staff member are recovering addicts.

10 Medical Influences on Treatment In 1957 the American Medical Association (AMA) endorsed the concept of alcoholism as a disease. Within addiction treatment, medical detoxification in one of the most widely used applications of medical services. This is the process in which an alcoholic or other drug addict withdraws from foreign substances under medical supervision, occasionally with the brief use of tranquilizers. Other pharmacotherapy interventions for alcohol and drug abuse have been used.

11 Activity Time Think and Share (Highlighted Handouts) (Pages: ) Be ready to share

12 Treatment Placement Criteria and Continuum of Care Two of the major influences on modern treatment are the patient placement criteria established by the American Society of Addiction Medicine (ASAM), and the concept of a continuum of care. The ASAM placement criteria can be used to help determine the severity of an individual s substance-use problems and the appropriate level of intervention. The continuum-of-care concept is in response to a realization by researchers and clinicians that alcohol and drug disorders are not acute illnesses and will rarely be cured with one brief treatment. Although there are criteria s that are in place and being used it is expected to continue to evolve in response to research findings and clinical practice based on society.

13 Legislation and Authority The Hughes Act of 1970 recognized alcohol abuse and alcoholism as public health problems and created the National Institute on Alcoholism and Alcohol Abuse (NIAAA), the primary funding source for research related to the causes and treatment of alcoholism. The National Institute on Drug Abuse was established in 1974 as the federal focal point for research, treatment, prevention, and training services. Its mission changed in 1981, when legislation created the Block Grants Programs, which gave states more control over treatment and prevention services. A series of federal laws, including the Comprehensive Crime Control Act of 1984, and the Anti-Drug Abuse Acts of 1986 and 1988, increased sanctions for drug offenses and trafficking. In 1962, a U.S. Supreme Court decision held that it was cruel and unusual punishment to imprison persons under California law who had the illness of narcotic addiction, hence the reason for federal support for treatment efforts.

14 Funding Funding for alcohol and drug treatment programs varies dramatically from state to state. It is important for the counselor to understand the funding mechanisms that will be relevant for any individual he or she might refer to treatment. It is important to determine if a given treatment provider receives state funds that can help defray the cost to the individual, the individual s insurance benefits, and whether a treatment provider is certified to receive compensation from the individual s insurance plan. Each state typically commits a portion of its general revenue to services for alcohol and other drug treatment. States that receive funding from grants usually have a section in the grant dedicated to subsidizing alcohol and drug treatment services. What about Medicaid Well, Medicaid-eligible individuals referred to Medicaid-certified providers can receive treatment services included in the state plan without incurring personal charges, as the provider will be reimbursed by the state Medicaid Program.

15 Client Services Drug and Alcohol abuse treatment centers provide a variety of services. Most centers provide assessment services and one or more of the following: outpatient, residential/inpatient, and continuing care. Many centers offer additional services, such as detoxification, intensive outpatient, and educational programs. Assessment: Determination of individual s severity of his or her alcohol or drug problems and problems in other life areas. This assessment helps the staff member decide what is the best plan for the patient. Detoxification: During this time the patient will receive supportive nursing care and pharmacotheraphy for withdrawal. Remember that detoxification is not a treatment, it only helps the individual attain physical and mental readiness for beginning treatment.

16 Client Services Outpatient Services: Less costly alternative to residential/inpatient treatment, allowing the individual to go about their daily responsibilities. Two types of Outpatient Services: Outpatient and Intensive Outpatient Intensive Outpatient Treatment will typically meet more frequently and for a greater amount of time each week so that they provide more structure and a higher dosage of treatment. Once the patient is starting to show signs of improvement, that s when the patient will be referred to the outpatient treatment. Outpatient treatment is not recommended for individuals whose substance-use frequency and problems have progressed or social support in their environment. Residential/Impatient Services: Are highly structured and provide intensive alcohol and drug education, individual and group therapy, and self help group meetings. Continuing Care Services: Follow up services to help an individual maintain progress made while in residential/inpatient treatment. The main purpose of continuing care are to monitor, support, and reinforce the use of new skills to help decline the rate of relapse.

17 Activity Time THINK and SHARE: What kinds of Alcohol-Drug Services do we have in the CNMI? Be ready to share

18 Student Learning Outcomes (SLO s) Were we able to Understand and retain the four pivotal events prior to 1940? Describe the History of Alcohol-Drug Treatment Programs? Understand how medicine plays a significant role in addiction treatment? Understand the two major influences on modern treatment? Understand the Legislation, Authority and Funding? Knowing the different kinds of Client Services?

19 Thank-You

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