Transcript Cedar Mountain Center - Alcohol The #1 Abused Drug

Cedar Mountain Center
Trends and Developments in
Substance Abuse Treatment
Kim Fletcher
Marketing Director
Personal and Professional
Implications
• Criminal Justice System jammed
• Epidemic Proportions
• No Socioeconomic Boundaries
Disease or Moral Weakness
• Science is clear on disease
• Stigma attached which is a barrier to
treatment
• Mandated treatment does work
– Drug Courts
– Prisons
– Department of Family Services
#1 Abused Drug
Alcohol
Cost to Society
Half a Trillion Dollars
• Crime Related Costs
• Loss in Productivity
• Break Down:
– Alcohol-185 Billion
– Illicit Drugs-181 Billion
– Tobacco-168 Billion
Cost to Society
(Billions of Dollars)
185
180
175
170
165
160
155
Alcohol
Drugs
Tobacco
Monitoring the future
Survey of 50,000
8, 10, and 12 graders by NIDA
• Decline in use
• Exception are Ecstasy, Oxycotin, Vicodin
and inhalants
• Report by NIDA – monitoringthefuture.org
Addiction: Bio-psycho-social
disease
• Biological - Genetic Tendency
• Psychological – Beliefs
• Social – Drinking culture
– Learned behavior
– Environment
Brain Imaging
• Exposure to psychoactive chemicals
cause changes in the brain that can be
seen with brain imaging
• Changes in critical areas:
– Decision making
– Learning and memory
– Behavior control
• Cravings and triggers – choose drug
despite catastrophic consequences
Culture of Substance Abuse
• Parental modeling
– Adolescents want to mimic adults
– Will use substances to cope with problems
• Parental indifference
– We used and we turned out alright
– Today's drugs are more potent
• Best place to find beer
– In the fridge right next to the milk
Co-dependency
• Making excuses for the user
• Covering up for the user enabling their
use to continue
Co-dependents develop their own self-destructive
behaviors for coping
Victims of child abuse/neglect due to substance use often
go on to become CHINS and delinquency cases
Diagnostic Manual of Mental
Disorders – Psychiatric Assoc.
• Differentiates between Substance Abuse
and Substance Dependence
• Relies on the pattern and duration of drug
use
• The negative impact of drugs on the social
and occupational functioning of the user,
and the pathological effects to confirm a
diagnosis of addiction or dependence
Physical vs Psychological
Dependence
• Misconception that an addict uses
everyday
• Binge use
• Causing significant life problems
• Compulsively seeking and using despite
negative consequences
Addiction Severity Index
• Most Comprehensive
• 186 criteria for diagnosis of Chemical
Dependency
Screening Tools
• CAGE – 4 questions, highly reliable for alcohol
 have you ever felt you should CUT DOWN on your
drinking?
 have people ANNOYED you by criticizing your
drinking?
 have you ever felt bad or GUILTY about your
drinking?
 EYE OPENER: have you ever had a drink first thing in
the morning to steady your nerves or
to get rid of a hangover?
Does treatment work?
Research shows that when appropriate
treatment is given and when clients follow the
prescribed program, treatment does work.
In 1999 the National Institute of Health published
“Principles of Drug Addiction Treatment, 13
principles of effective treatment.”
National Institute of Health
13 Principles of Effective Treatment
#1 No single treatment is appropriate for all;
match treatment settings and
interventions to the individual
Principles of Effective Treatment
#2 Treatment needs to be readily available
potential applicants can be lost if
treatment is not immediately available
Principles of Effective Treatment
#3
Effective treatment attends to the
multiple needs of the individual
Principles of Effective Treatment
#4 Treatment and service plan must be
assessed continually and modified as
necessary
Principles of Effective Treatment
#5 Remain in treatment for an adequate
period of time
Principles of Effective Treatment
#6 Counseling (individual and/or group) and
other behavioral therapies are critical
components
Principles of Effective Treatment
#7 Medications are an important element of
treatment
Principles of Effective Treatment
#8 Dual disorders should be addressed in
in integrated way
Principles of Effective Treatment
#9 Detox is only the first state and does
little to change long term use
Principles of Effective Treatment
#10 Treatment doesn’t need to be voluntary
to be effective
Principles of Effective Treatment
#11 Drug use during treatment must be
monitored continuously
Principles of Effective Treatment
#12 Treatment programs should provide
assessment for HIV/AIDS, Hepititis B
and C, tuberculosis, and other
infectious diseases as well as
counseling to help patients modify or
change behaviors that place
themselves at risk of infection
Principles of Effective Treatment
#13 Recovery from drug addiction can be a
long-term process and frequently
requires multiple episodes of treatment
Resources
• Most current information available from:
– National Institute on Drug Abuse (NIDA)
– National Institute on Alcohol Abuse and
Addiction (NIAAA)
• Cedar Mountain Center’s 30 years of
treatment experience
• Personal Experience – 50 years