Transcript substance use disorders

Recreational Therapy: An Introduction
Chapter 5: Substance Use Disorders
PowerPoint Slides
Substance use disorders
In 2012, an estimated 23.9 million Americans age 12 or older—or
9.2% of the population—had used an illicit drug or
psychotherapeutic medication (e.g., pain reliever, stimulant) for
other than its intended use, in the previous month.
Alcoholism and alcohol use disorders (AUD)
 Alcoholism and alcohol use disorders are regarded as the most devastating of
all health conditions in terms of economic and social costs, affecting 17
million Americans.
 Approximately 53% of adults in the U.S. have reported that one or more of
their close relatives have a drinking problem.
Substance use disorders
Formerly known as substance abuse, the condition is now called
substance use disorders reflects the assumption that persons who
use different substances have different disorders with unique
features, which range fro middle to moderate to severe. Not
everyone who has the disorder suffers from addiction.
Addiction
The word addiction is the preferred term for persons who
experience compulsive use despite serious health and social
consequences. Addiction is often chronic in nature; it disrupts
circuits in the brain that are responsible for reward, motivation,
learning, judgment, and memory, making recovery challenging.
Medical treatment of substance use disorders
 Substance use disorder is a chronic condition that has a high rate of relapse
and may require multiple admissions for treatment and ongoing intervention.
 Treatment for substance use disorders typically begins with medically
supervised detoxification to clear the body of the toxic substances, but detox
alone does not produce long-term recovery.
 Several medications are used in treatment, including Antabuse (which makes
users sick if they drink alcohol) and naltrexone (which blocks the rewarding
effects of alcohol and reduces cravings). For opiate addiction, methadone,
Suboxone, and buprenorphine work by reducing symptoms of withdrawal,
reducing the cravings for the drug and blocking the effects of the opiates.
Therapeutic approaches
 Traditional approaches include therapeutic communities, 12-step support
groups, community reinforcement, cognitive-behavioral therapy,
multidimensional family therapy, multimodal interventions, and a holistic
approach to developing a healthy lifestyle.
 New methods include screening, brief intervention, and referral to treatment to
behavioral health care; motivational interviewing; motivational enhancement
therapy; and complementary and alternative methods such as massage, yoga,
and qigong.
 Table 5.3 details current treatments for substance use disorders.
Leisure education
 Leisure education is increasingly being included as an essential component of
treatment for substance use disorders.
 The importance of fun and joy in recovery is being recognized.
 Pleasure and play have been seen as sources of hope, commitment, meaning,
and purpose and as a means of discovering individual strengths, talents, sense of
control, and mastery.
Examples of RT interventions with empirical evidence
to support them
 Adventure therapy
 Mindfulness
 Animal-assisted therapy
 Qigong
 Horticulture
 Relaxation and stress management
 Photography
 Multimodal interventions using recreation
 Physical activity
 Family social events
 Bibliotherapy
Outcomes to which RT may contribute
 Number of days without relapse
 Ability to identify triggers and resist
urges
 Effective use of stress management
strategies and coping skills
 Increased impulse control and
frustration tolerance
 Improved family relationships and
communications
 Developing a support network
 Acquiring social skills
 Recognizing strengths and assets
 Developing trust
 Making new friends
Outcomes specific to recreation & leisure
 Increasing leisure awareness
 Identification of leisure barriers
 Identification of interests, skills, and
resources
 Identification of rewarding alternative
activities to substance use
 Acquiring a repertoire of leisure
activities to do along or with others
 Implementing a plan for leisure
participation
A note of caution for RTs
RTs may find their work with substance use disorder clients
to be emotionally difficult and frustrating at times.
Addressing work stress through clinical supervision and
holistic health practices may strengthen staff’s ability to
continue being effective and satisfied with their work.