soc 204 goldberg ch 15 treatment

SOC 204 Drugs & Society

Chapter 15 Substance Abuse Treatment

Goldberg

Attendance:How are you doing?

A. Doing GREAT!

B. Okay

C. Feeling stressed

Doing G

REAT!

Okay

Feelin

g str

essed

0% 0%0%Response

Treatment Videohttp://digital.films.com/PortalViewVideo.aspx?xtid=30

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Treatment & Recovery

• Defining treatment goals

• Programs:

• Inpatient

• Outpatient

• Counseling

• Individual

• Group

• Family

• Pharmacotherapies

• AA and other 12-step models

Before we can evaluate the success of a drug treatment program, we have to understand the

program’s

A. Administrative structure.

B. Training requirements.

C. Goals.

D. Theoretical approach.

Admin

istra

tive st

ruct

ure.

Train

ing r

equirem

ents.

Goals.

Theoretic

al appro

ach.

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Response

Opinion: What do you think the

goal of treatment should be?

A. Complete abstinence

B. Controlled substance use

C. Helping the user make better decisions

D. Other Comple

te a

bstin

ence

Controlle

d subst

ance u

se

Helpin

g the u

ser m

ake be...

Other

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Response

Stages of Change

• Motivational Enhancement Interview• Resistance

• Client• Community

The goal of motivational enhancement is

1. To confront the user with his/her negative behavior

2. Find alternatives to substance use

3. Encourage the user to move to another stage of change

To confro

nt the u

ser w

ith...

Find a

ltern

atives t

o subs..

.

Encoura

ge th

e use

r to m

...

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Response

How was your Thanksgiving?

A. Awesome!

B. Too short.

C. Okay.

D. Don’t ask.

Aweso

me!

Too short

.

Okay.

Don’t as

k.

25% 25%25%25%

Response

Drug Courts

• Drug treatment courts combine the power of the justice system with effective treatment services

• First drug court was established in 1989 for nonviolent drug offenders whose underlying problem is substance use

• Offenders who complete substance abuse programs may have their sentences dismissed or reduced

Treatment

• Contingency Management

• Cognitive Behavioral Therapy (CBT)

• Pharmacotherapies

• Detoxification

• Maintenance

The most widely used treatment for

substance abuse is:

A. Motivational enhancement

B. Pharmacotherapy

C. Cognitive-behavioral therapy

D. Detoxification

Motiv

ational e

nhancem

ent

Pharmaco

thera

py

Cognitive

-behavio

ral t

he...

Detoxifi

catio

n

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Response

The goal of the maintenance

phase of treatment is

A. Preventing seizures

B. Preventing cross tolerance

C. Preventing relapse

Preventin

g seizu

res

Preventin

g cro

ss to

lera

nce

Preventin

g rela

pse

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Response

The Big Picture

Is Treatment Effective?

• Relapse

• Factors:

• Negative emotional states

• Interpersonal conflicts

• Social pressure

Benefits of Treatment

• Less expensive than incarceration

• Reduced use of illicit drugs

• Decline in criminal activity

• More stable employment

• Reduced transmission of AIDS

• Reported benefits:

• Drug use declined from 73% before treatment to 38% one year after treatment

• Increase in employment from 51% to 60%

• Decline in clients receiving welfare from 40% to 35%

• Drop in homelessness from 19% to 11%

• 53% decline in substance-related medical visits

• 56% reduction in people exchanging sex for drugs

• 51% drop in people having sex with an IV drug user

Treatment Issues

• Four pertinent issues in treating drug abuse:

1. Voluntary or compulsory treatment

2. Matching patients to the best treatment

3. Effectiveness of treatment programs designed for adults for adolescent substance abusers

4. Programs to address female addicts

Reasons Women Avoid Treatment

Barriers

• Client Resistance to Treatment:• Many treatment facilities are not readily available or

accessible

• A large percentage of clients lack insurance and cannot afford the cost of treatment

• Policies and philosophies of some facilities deter drug abusers from pursuing help

• Benefits of using drugs outweigh the disadvantages

• Clients think that legal authorities will be made aware of their drug-taking behavior if they enter treatment

Barriers

• Community Resistance:

• People do not want drug treatment centers in their neighborhoods

• Concerned about more crime, more traffic, exposure of children to bad influences, and lower property values

• NIMBY (not in my backyard) syndrome

Barriers

• Continuing Drug Use:

• The goal of abstinence is often not realized

• Treatment of at least six months seems to be necessary to reduce drug use significantly

• One study of adolescents in treatment reported that drug usage declined somewhat, but remained high

Barriers

• Factors that contribute to relapse among alcoholics:

1. Negative emotional states such as frustration, anxiety, depression, anger, or boredom

2. Interpersonal conflicts with a spouse, family member, friend, or employer

3. Social pressure from a person or group of people

Barriers

• Factors in Personnel Recruitment and Retention:

• Reluctance to work with drug abusers

• Undesirable locations of facilities

• Inadequate supply of applicants with professional experiences and qualifications

• Fear of contracting AIDS