recreational therapy: an introduction chapter 5: substance use disorders powerpoint slides
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Recreational Therapy: An IntroductionChapter 5: Substance Use Disorders
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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
Animal-assisted therapy
Horticulture
Photography
Physical activity
Bibliotherapy
Mindfulness
Qigong
Relaxation and stress management
Multimodal interventions using recreation
Family social events
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.
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