Transcript De Paul Treatment Centers

Substance Use and Treatment in Schools
Current Statistics
• Over 12% of Oregonians 12 and over reported illegal drug use
in the past 30 days- second highest in the country
• Alcohol and illegal drug use by Oregon 8th graders is nearly twice
the national average (22.5% and 16.7% respectively)
• Over 3,500 youth 12 to 17 in Multnomah County abuse or are
dependent on illicit drugs
• 29% of Multnomah County 11th Graders reported binge
drinking in the past 30 days
Sources: Student Wellness Survey 2010, Monitoring the Future 2010
Alcohol, Illicit Drugs & Tobacco Consumption and Consequences
in Multnomah County, Oregon 2000-2006
Prevalence
• Alcohol-related disorders occur in up to 26% of
the general population, a prevalence rate similar
to that of other chronic diseases such as
hypertension and diabetes (Fleming and Barry, 1992)
Health Impacts of Alcohol and Drugs
• 72 conditions requiring
hospitalizations are wholly or partially
attributable to substance abuse
(Center on Addiction and Substance Abuse, 1993, p. 21)
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Trauma, disability
Sexual dysfunction
HIV/AIDS, other STDs
Weight gain (alcohol) , weight loss
(stimulants)
Other Common Co-morbidities
• Mental health issues such as:
mood disorders (depression and
bipolar disorder), personality
disorders, and ADHD
• Cognitive delays due to Fetal
Alcohol Effects Syndrome or
effects of other drugs used while
prenatal
• History of neglect, abuse and/or
unresolved traumas
Helping Students
An Overview of the Sections that follow:
• Warning signs that a student is suffering from a chemical dependency
• What to do when dealing with a student whom you suspect is
chemically dependent
• How to refer someone to treatment
• Roadblocks to overcoming dependency
• Different types of treatment (residential, outpatient- group and
individual)
• Resources
Symptoms That Suggest SUDs
• Physical problems (see previous slide)
• DUII, falls, accidents, injuries
• Dysphoria, depression, anxiety,
irritability, mood swings, hostility
• Family or relationship dysfunction
• Frequent lateness to school, absences,
decline in performance
• Changes in friends or activity level
What to do When Dealing With a Student You
Suspect is Struggling With Use
• Address the issue head on
• Be tactful in your approach
• Start by showing empathy: "I have noticed your grades
declined a bit, and that must be hard on you”
• Ask open ended questions: “tell me what is concerning
you right now…what else?”
• Listening is fundamental
What to do When Dealing With a Student You
Suspect is Dependent
• After building rapport and listening, ask if it is OK to
give the student a screening tool. Don’t apologize for it,
just give the tool and ask the student to fill it out.
• Read the results and reflect back to the student: “So
you drink more than 2 drinks a night, and sometimes
up to 5 in one sitting, tell me more about it.”
Brief Three Question Screen
#1: In the past year did you ever drink or used drugs more than you meant to?
Positive response = anything other than definitive no!
#2: In the past year have you ever thought you should cut down on your alcohol
or drug use?
Positive response = anything other than definitive no!
#3 for Boys: when was the last time you had more than 5 drinks at one sitting?
#3 for Girls: when was the last time you had more than 3 drinks at one sitting?
Positive response = within the last 3 months.
Go to mini assessment if positive response to any question.
If a Student Screens Positive
Next step is to conduct this 5 question mini
assessment:
• #1 - How much do you drink on a typical drinking day?
How much do you use (drugs) on a typical using day?
• #2 - How often do you drink/use on a typical Monday
through Sunday week?
Mini Assessment (cont.)
• #3 - Tell me about the consequences you may have had
with drinking or using? (DUIIs, conflict with spouse or
family members, missed school, etc)
• #4 - Have you ever made attempts to cut down or stop
drinking (or using)?
• #5 - Is there an immediate family member who has a
substance use disorder (alcoholism, drug addiction)? Who?
What to Do Now?
• How to talk to individuals
who screen positive?
• Think about:
 Stages of Change
 Motivational Interviewing
 Brief Intervention
Stages of Change
Relapse
Permanent Exit
Pre-contemplation
Maintenance
Contemplation
(ambivalence)
Action
Determination
(commitment)
Sources: Prochaska & DiClemente
Motivational Interviewing
• MI spirit – empathic, collaborative, respects
person’s autonomy to make own decisions
• Handles resistance skillfully
• Aims at eliciting reasons to change from the
student (does not aim at arguing for change)
• Works on ambivalence
Motivational Interviewing
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Appreciation for person’s opinions
Decision making is shared
Provides menu of options
Uses the person’s reactions to guide next strategy
Resist fixing the person or lecturing
Use open ended questions
Do pros and cons
Brief Intervention
• Following the Mini Assessment, use MI to see
what the student is willing to do by asking:
• Given the risks of drinking/using at this level,
would you be willing to try to quit for a while?
• How about reducing to safer levels?
• Could you try to drink only one drink a day
(girls) or two a day (boys)?
Decision Aid for Making
Recommendations and Referrals
If symptoms of depression or family history exist, use the
following:
Dep Sx
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Fam Hx
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Initial Recommendation
Consult with specialist
Abstinence
Cut down to low-risk level
Brief Intervention and Referral Steps
If recommendation is declined, then try…
Negotiation:
1) Refer for assessment at De Paul– declines →
2) → Abstain completely – declines →
3) → Cut down to low risk level – declines →
4) → Cut down as much as willing →
5) → Accept decision and plan to readdress in the
future → Follow up
A Decisional Balance Ambivalence Cross
Status Quo
Current Situation
Change
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Roadblocks to Overcoming SUDs
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Post Acute Withdrawal Symptoms
Changes in the neural pathways of the brain
People, places and things (triggers and warning signs)
Change is difficult, is there support?
Internal vs. External Motivators
Stigma and Societal Norms
Relapse is frequently a part of the process
Family Involvement
• Family involvement in treatment
is vital!
• At De Paul, adult residential
clients whose families participate
in treatment have a 77%
successful completion rate
compared to 48% for those
without family involvement.
CRAFT
• Stands for Community Reinforcement and Family
Training
• Focuses on enhancing a loved one’s motivation to get
sober while improving the personal wellness of the
concerned significant other
• Uses communication skills and positive reinforcement
for sobriety (not ultimatums or confrontation)
• Has a 70% success rate of getting loved ones into
treatment in clinical studies
De Paul Treatment Centers
Mission Statement:
De Paul Treatment Centers works with individuals,
families, and communities to create freedom from drug
and alcohol addiction.
De Paul serves the community and those affected by the disease of
addiction. Using proven and effective treatment strategies, De
Paul strives to build healthy and hopeful communities in recovery.
De Paul Treatment Centers
Our Philosophy:
• We recognize that addiction is a complex, chronic,
and treatable illness resulting from an interaction of
human biology, environment, and behavior.
• We believe that all individuals have the innate health
and capacity to recover.
• We believe recovery happens in the context of
relationship and community.
• We respect the dignity and recognize the uniqueness
of each individual and the need for individualized
treatment.
De Paul Programs
Men and Women - Downtown & Hillsboro
Youth – NE Portland & Hillsboro
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Adult Detox – insured and self pay
Medication Assisted Treatment
DUII
Family Treatment with or without identified client
Assessment
Information and Referral
Residential Treatment
Outpatient and Intensive Outpatient
Case Management Services
• Integrated Mental Health and Substance
Use Disorder Treatment
• Recovery Support – host a variety of
community support meetings and the
Alumni group
Youth Services
• Family-centric Program
• Residential Treatment
• Individual Family Therapy
• Multi-family Groups
• Intensive Outpatient and Outpatient Treatment
• Mental Health Assessment and Treatment
• De Paul Alternative School
• DP Fit- youth fitness program
• Recovery Groups
• CRAFT- counseling for parents whose teens are
resistant to treatment
Accessible Treatment
• Contracts with most insurance companies
• Sliding scale for those who wish to self pay
• 30 day residential packages including family
therapy and outpatient treatment
• OHP
• Funded slots
De Paul Treatment Centers
www.depaultreatmentcenters.org
503-535-1151 (Downtown- Adult)
503-535-1181 (NE- Youth)
503-693-3104 (Hillsboro- Outpatient)