Transcript Using a Systems Approach in Treating Parents with

JUST SAY KNOW:
FACTS ABOUT PSYCHOACTIVE DRUGS
Rick Csiernik, King’s University College at Western University
,
[email protected]
Definitions
PSYCHOACTIVE DRUG – alter the CNS while also affecting
the ANS
DEPENDENCY- physical and psychological
ADDICTION – physical dependency + psychological
dependency + social context of drug use
Psychoactive Drug
Substances that alter brain functioning by decreasing, increasing or disrupting
central nervous system activity.
This in turn produces changes in mood, perception, sensation, need,
consciousness, and other psychological functions and ultimately produces
changes in behaviour.
These substances influence a great number of physiological functions mediated
by the autonomic nervous system that are outside the realm of conscious
control such as respiration, cardiovascular function and hormonal balance.
Psychoactive Drugs
& Addiction
.
Biological
Biopsycho
.
Biosocial
ADDICTION
Psychological
Psychosocial
Social
What Psychoactive Drugs Do
Categories
Depressants – Benzodiazepines, Barbiturates, Alcohol, Solvents, Antihistamines
- Opioids (Codeine, Morphine, Oxycontin, Heroin, Methadone)
Stimulants - Cocaine, Amphetamines, Ritalin, Decongestants, Nicotine, Caffeine
Hallucinogens – LSD, Ecstasy, Ketamine, Cannabis
Psychotherapeutic Agents – Anti-Depressants, Anti-Psychotics, Mood Stabilizers
What is NOT an addiction
Why are these not an addiction?
Eating Disorders
No Psychoactive Change to Brain
Compulsive Behaviours:
Shopping, Internet Use, Sex
Different Treatment Approach
Different Treatment System
Problem Gambling
Different Policies
STOP
│
│
CONTACT
─────┼────────────┐INTEGRATED (casual/occasional)─────┬──────────┐
WITH DRUG
│
│
USE
│
│
│
│
│
│
│
│
┌─STOP
│
│
│
│
│
│
│
EXPERIMENTATION
└──────EXCESSIVE───┼─RETURN─────────┘
│
(curiosity/peer
USE
│
│
pressure)
├─STABLE
│
│ STATE
│
│
┌─STOP
│
│
│
│
└──────ADDICTION│
│
├─STABLE
│
│ STATE
│
│
│
├─PROGRESS │
│
│
└─RETURN────┘
Client
Responsibility
For Solution
Treatment
Philosophy
high
low
high
MORAL
ENLIGHTENMENT
low
COMPENSATORY
MEDICAL
Client
Responsibility
For Problem
PREVENTION &
HEALTH PROMOTION
EARLY IDENTIFICATION
self
family
friends
school
family physician/medical system
workplace/Employee Assistance Program
Case
Management
social agencies
Assessment &
Referral
legal system
Withdrawal
Management
And Daytox
clergy
Community
Resources
●
●
Medical Treatment
●
ADDICTION RESOURCES
Outpatient Counselling
Harm Reduction Initiatives
Concurrent Disorder Programming
Short Term Residential Programs
Recovery Homes
Alternative Living Environment/Housing Supports
RELAPSE PREVENTION
Self Help Groups
Leisure Activities
●
●
Legal Services
Employment Assistance
●
Financial & Debt
●
Counselling
●
Marital & Family
Counselling
Drug Testing
◦ Appropriate selection bias
◦ People with positive results  Likely to have issues
◦ People are selected for drug testing based on existing parenting concerns
◦ Continued use
recreational use
◦ Substantial negative consequences
Effective use of Drug Tests
Drug testing provides an objective basis to demonstrate that drug
use or drug involvement has occurred
The meaning of the drug test in any one case is dependent on
contextual factors
◦ What behaviours does this person exhibit while using?
◦ How has use affected this person in the past?
What Can Drug Testing Tell Me ?
Through hair & urine analysis:
◦ That the subject used a drug during a particular period of time
◦ That the subject is frequently associating with drugs or heavy users (hair analysis)
◦ Determination of passive exposure
◦ Child exposures  use in the context of parenting
◦ Improving; unchanged; ongoing use
◦ What are the implications with prescription drugs (methadone, medical marijuana,
sedative-hypnotics)
What Drug Testing Cannot Tell You
The exact pattern of drug use
How intoxicated the subject gets when using
How the drug use impacts the subjects parenting abilities
The method of drug administration
◦ I.V. / oral / smoked / insufflated
Whether someone is abusing a drug that they are prescribed
◦ (opioids including methadone, medical marijuana, sedative hypnotics like Ativan, anti-depressants like Prozax)
Drug testing does NOT indicate addiction nor dependency
References
Csiernik, R. (2014). Just Say Know: A Counselor’s Guide to Psychoactive Drugs. Toronto: Canadian Scholars Press.
Csiernik, R. (2011). Substance Use and Abuse: Everything Matters. Toronto: Canadian Scholars Press.