WASTED INTRODUCTION OF SUBSTANCE ABUSE BRIAN L. BETHEL, M.ED, PCC-S, LCDC III, RPT-S 1
Activity #1: Please listed to the guided visualization activity and then list your reactions and common feelings to the guided visualization. THE NUMBERS: Accurate statistics regarding substance use and child abuse are difficult to determine Most studies indicate that between and of substantiated child abuse and neglect reports involve substance abuse. out every 10 cases on child welfare caseloads involve some type of addiction issue. % of children removed during (CPS) investigations were listed on a case with a contributing factor of alcohol or drug abuse. % of all substance abuse treatment clients were parents of dependent children. billion dollars of child welfare monies are tied to substance addiction. Between and million Americans have abused prescription medications in the past month. % of all child welfare officials report an increase in out of home placements because of meth in the last year. million people in the US have tried marijuana ( % of the population). 2
Activity # 2 What are the most commonly abused drugs in the United States? 1. 2. 3. 4. 5. WHAT IS A DRUG? Something we take into our bodies via ingestion, inhalation, absorption, or injection. Changes the way we think or feel Once it is in the blood stream, we cannot stop the drug from working Includes over the counter, prescription, and illegal drugs (medicine, legal and illegal) THE BENEFITS OF DRUGS: Every drug known to mankind has been developed for some type of benefit(s). Fight infection; Reverse a disease process; Relieve symptoms of illness; Restore normal functioning of human organs; Aid in diagnosing sickness Maintain health. SO WHAT S THE PROBLEM? Drug abuse is a disease. Identified as an epidemic. (Latin) addictus---attached to something, positive. 3
THE NUMBERS: Between and million Americans have abused prescription medications in the past month. million people in the US have tried marijuana ( % of the population). million people abuse opiates worldwide. An estimated million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012. An estimated addicted to heroin. It is estimated that million Americans have used Meth at some point in their lifetimes. This translates to approximately % of the population It is estimated that there are million Meth users in the U.S. Bath Salts were linked to an estimated visits to hospital emergency departments in 2011. (SAMHSA) THE PROCESS OF ADDICTION: Dependency Pre-Occupation Abuse Social Use Experimentation 4
DIAGNOSTIC CRITERIA: PATTERNS OF USE SXS. RELATED TO USE PHYSICAL SXS. The substance is taken in larger amounts over a longer period of time than was intended. There is a persistent desire or unsuccessful efforts to cut down or control the use. A great deal of time is spent in activities necessary to obtain, use, or recover from effects Recurrent use resulting in failure to fulfill role obligations. Continued use despite having persistent social or interpersonal problems exacerbated by use. Important social, occupational or recreational activities are reduced due to use. Recurrent use in situations that are physically hazardous. Continued use despite knowledge of physical or psychological consequences. Craving or a strong desire or urge to use Tolerance, as defined by either: need for read amounts of the substance in order to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount Characteristic withdrawal syndrome for the substance; or the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms Symptoms in the criteria have to be present for a twelve month period. Mild Substance Use Disorder = 2-3 criteria Moderate Substance Use Disorder = 4-5 criteria Severe Substance Use Disorder = 6 or > criteria CULTURAL ISSUES AND SUBSTANCE ABUSE: GENDER ETHINICITY AGE DUAL DIAGNOSIS 5
SCREENING: Paraphernalia observed or reported in the home The smell of alcohol, marijuana, or other drugs on the parent or in the home A child reports use by adults in the home Parent s behavior suggests intoxication Parent exhibits signs of addiction Parent admits to substance use Parent shows or reports experiencing physical effects of addiction and/or withdrawal UNCOPE: U Have you continued to use alcohol or drugs longer than you intended? (Unintended use?) N Have you ever Neglected some of your usual responsibilities because of alcohol or drug use? C Have you ever wanted to Cut down or stop using alcohol or drugs bur couldn t? O Has your family, a friend or anyone else ever told you they Objected to your alcohol or drug use? P Have you ever found yourself Preoccupied with wanted to use alcohol or drugs? E Have you ever used alcohol or drugs to relieve Emotional discomfort, such as sadness, anger or boredom CAGE: C: Have you ever felt the need to cut down your drinking or drug use? A: Have you ever felt annoyed by people criticizing your drinking or drug use? G: Have you ever felt guilty about your drinking or drug use? E: Have you ever had a drink or used a drug first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)? TREATMENT: No single treatment is appropriate for all individuals. Treatment needs to be readily available. Treatment focuses on multiple needs of the individual not just drug use. Treatment does not need to be voluntary to be effective Recovery from drug addiction can be a long process and often requires multiple episodes of treatment 6
TREATMENT: 12- step programs IDDT Outpatient Services Inpatient Services Collaboration INTEGRATED TREATMENT: Treatment approach - Combine mental health & - Substance abuse treatment - Outpatient/inpatient - Comprehensiveness - Medication management - Outreach - Social support - STAGES OF TREATMENT & RECOVERY Stages of Treatment or Recovery and Tasks for Child Welfare Professionals Stages Transition stage The parent recognizes that her or his attempts to "control" or stop substance use are not working Stabilization stage The parent goes through physical withdrawal and begins to regain control of her or his thinking and behavior Early recovery stage The parent changes addictive behaviors and develops relationships that support sobriety and recovery Middle recovery stage The parent builds a lifestyle that is more effective and repairs lifestyle damage that occurred during substance use Tasks professional can foster strong linkages between parent and appropriate assessment and treatment resources, emphasizing a need for children's protection and family involvement. professional can ensure the parent knows the children are being cared for, thus allowing the parent to focus on securing needed help for her or his addiction. During this stage, child welfare professionals can help parents begin rationally considering the safety and nurturing needs of their children and the timetables and requirements he or she must meet. Also, child welfare professionals can assist with frequent and ongoing visitation between parents and children. professional can support the family's transition to parent-child reunification or placement of the children through ongoing family 7
Late recovery stage The parent examines her or his childhood, family patterns, and beliefs that supported a dysfunctional lifestyle. The parent learns how to grow and recover from childhood and adult traumas Maintenance stage The parent learns to cope in a productive and responsible way without reverting to substance use interventions. professional can facilitate access to continuing educational opportunities for parenting improvement and family strengthening. professional can continue supporting linkages with appropriate resources, such as housing, self-help groups, employment, which were discussed in more detail earlier in this module. PROBLEMS WITH METHADONE: Drug interaction Single dose overdose A Drug interaction Single dose overdose Accumulated toxicity cumulated toxicity SUBOXONE: Suboxone is the first opioid medication approved under DATA 2000 for the treatment of opioid dependence in an office-based setting. Suboxone also can be dispensed for takehome use, just as any other medicine for other medical conditions. 8