Download Chapter 15

Substance Abuse Treatment
PROFILE OF A DRUG ABUSER
 MOST PEOPLE IN TREATMENT ARE
BETWEEN 18-25 YEARS OF AGE
 MANY DRUG ABUSERS SUFFER FROM
MENTAL HEALTH PROBLEMS
 30-40% OF DRUG ABUSERS ARE
HOMELESS
 THOSE IN TREATMENT USE MULTIPLE
DRUGS
BENEFITS OF DRUG
TREATMENT
 LESS EXPENSIVE THAN
INCARCERATION
 ILLICIT DRUG USE IS REDUCED
 CRIMINAL ACTIVITY DECLINES
 MORE STABLE EMPLOYMENT
 REDUCED TRANSMISSION OF
BLOODBORNE INFECTIONS
Components to Treatment
1. Detoxification
2. Counseling
3. Support Groups
DETOXIFICATION
 THE GOAL OF DETOXIFICATION IS
SAFE WITHDRAWAL
 ANOTHER GOAL FOR
DETOXIFICATION IS PROVIDING FOR
A HUMANE WITHDRAWAL
 DETOXIFICATION SHOULD PREPARE
THE CLIENT FOR ONGOING
TREATMENT
COUNSELING
 AFTER DETOXIFICATION IT IS
CRITICAL FOR THE CLIENT TO BE
COUNSELED TO BEGIN TO DEAL
WITH THE ISSUES THAT WERE
CENTRAL TO USING DRUGS AS A
COPING MECHANISM
SUPPORT GROUPS
 SUPPORT GROUPS ARE IMPORTANT
TO ASSIST THE CLIENT TO STAY
CLEAN AND SOBER
TREATMENT ISSUES
 VOLUNTARY VERSUS COMPULSORY
TREATMENT
 MATCHING PATIENTS AND
TREATMENT
 TREATING ADOLESCENT DRUG
ABUSERS
PROBLEMS ASSOCIATED WITH
TREATMENT
 CLIENT RESISTANCE TO TREATMENT
 COMMUNITY RESISTANCE
 CLIENT PREFERS CONTINUING DRUG
USE
 RELAPSE
 PERSONEL RECRUITMENT AND
RETENTION
TREATMENT PROGRAMS
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METHADONE MAINTENANCE
THERAPEUTIC COMMUNITIES
OUTPATIENT TREATMENT
INPATIENT TREATMENT
SELF-HELP GROUPS
METHADONE MAINTENANCE
 METHADONE IS A SYNTHETIC DRUG
THAT ELIMINATES WITHDRAWAL
SYMPTOMS FROM OPIATES AND
PREVENTS AN OPIATE ADDICT FROM
EXPERIENCING EUPHORIA
 METHADONE MAINTENANCE IS
EFFECTIVE ONLY FOR HEROIN
METHADONE MAINTENANCE
 THE DEMAND FOR METHADONE
MAINTENANCE IS HIGH
 WAITING LISTS FOR METHDONE
MAINTENANCE PROGRAMS CAN BE
UP TO ONE YEAR
THERAPEUTIC COMMUNITIES
 THERAPEUTIC COMMUNITIES (TC) ARE DRUGFREE RESIDENTIAL SETTINGS WHERE
ABUSERS RESIDE FOR 1-2 YEARS
 TCs STRESS GROUP INTERVENTION
TECHNIQUES AND LIFE IN A TC IS VERY
STRUCTURED WITH CLIENTS BEING GIVEN
CHORES (HENCE COMMUNITY)
 THE BIGGEST PROBLEM IN TCs IS THE HIGH
DROPOUT RATE
OUTPATIENT TREATMENT
 OUTPATIENT TREATMENT INCLUDES
COUNSELING, GROUP THERAPY,
VOCATIONAL/EDUCATIONAL
SERVICES
INPATIENT TREATMENT
 INPATIENT TREATMENT ARE
HOSPITAL BASED
 INPATENT TREATMENT HAS BEEN
SHOWN TO BE NO MORE EFFECTIVE
THAN INTENSIVE OUTPATIENT
TREATMENT
SELF-HELP GROUPS
 SELF-HELP GROUPS HELP PEOPLE TO
STAY CLEAN AND SOBER
 EXAMPLES INCLUDE ALCOHOLIC
ANONYMOUS
 ALCOHOLIC ANYONMOUS IS A
POPULAR SELF-HELP GROUP THAT
FOLLOWS A 12 STEP MODEL
REASONS FOR NOT SEEKING
TREATMENT
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UNAVAILABILITY OF FACILITIES
COST OF TREATMENT
STIGMATIZATION
FACILITY PHILOSOPHY
SOME PREFER DRUG USE
FEAR OF BECOMING KNOWN TO LAW
ENFORCEMENT
FACTORS THAT PREVENT DRUG
RELAPSE
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Marriage
Steady Employment
Compulsory Supervision
New Relationships
Belonging to a Desirable Group
A Substitute Dependency
ALCOHOL TREATMENT
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ALCOHOLICS ANONYMOUS
MODERATE DRINKING
DISULFIRAM
NALTREXONE
ALCOHOLICS ANONYMOUS
 THE MAIN FOCUS OF THE 12 STEP
MODEL IS THAT A PERON ADMITS TO
BEING POWERLESS OVER ALCOHOL
AND CANNOT OVERCOME
ALCOHOLISM WITHOUT ASSISTANCE
FROM A HIGHER POWER (RELIGIOUS
CONVICTION IS IMPORTANT)
 THE ONLY REQUIREMENT FOR AA IS
THE DESIRE TO STOP DRINKING
MODERATE DRINKING
 MODERATE DRINKING IS A
CONTROLLED DRINKING APPROACH
WHEREBY THE ALCOHOLIC CAN
RESUME DRINKING IN A MODERATE
WAY
 AN EXAMPLE OF MODERATE
DRINKING INCLUDES MODERATION
MANAGEMENT (MM)
DISULFIRAM (ANTABUSE)
 DILSULFIRAM (ANTABUSE) IS A
DRUG THAT WHEN TAKEN ACTS AS
AN ADVERSIVE AGENT BY
INTERACTING WITH ALCOHOL IN
SUCH A WAY THAT THE DRINKER
BECOMES VIOLENTLY ILL WHEN
HE/SHE COMSUMES ALCOHOL
NALTREXONE
 NALTREXONE TRADITIONALLY IS
USED TO BLOCK THE EFFECTS OF
OPIATES BUT HAS BEEN SHOWN
EFFECTIVE IN ALCOHOL TREATMENT
Summary
 Most people in treatment are between 18-25
years of age
 Substance abuse treatment has documented
benefits
 Detoxifcation, counseling, and support groups
are key elements to treatment
 There are a wide variety of treatment options
available
 The more structure to one’s life relapse is less
likely