ADDICTION

Jean Sassatelli RN, MSSenior Director Behavioral Health Services

Catholic Charities of Omaha

WHAT IS ADDICTION

When the use of alcohol and/or mood altering drugs causes problems in the individual’s family, social, work, school, legal, physical and/or emotional aspects of their life.

WHAT IS ADDICTION

Addiction is a pathological love relationship with a mood altering chemical, (or activity – i.e. gambling, sex, food).

(McAuliffes’ Essentials of Chemical Dependency)

BEHAVIORAL SIGNS ADDICTION

Change in attitude/personality for no identifiable reason.

Change in friends, new hangouts Decreased performance at school,

work and/or home. Change in activities or hobbies Change in habits at home Loss of interest in family and family

activities

BEHAVIORAL SIGNSADDICTION

Forgetfulness and difficulty paying attention

Lack of motivation, energy, self-esteem… ‘I don’t care’ attitude

Sudden over sensitivity, temper tantrums

Moodiness, irritability, or nervousness Silliness or giddiness Paranoia

BEHAVIORAL SIGNSADDICTION

Excessive need for privacy Secretive or suspicious behavior Chronic dishonesty Unexplained need for money Change in personal grooming Sudden change in wardrobe,

hairstyle, or jewelry

ADOLESCENT ADDICTIONUsage by Youth in Grades 9 -12

Alcohol: 82% Marijuana: 31% Inhalants: 13% Meth.: 8% Cocaine: 7%

1999 Youth Risk Behavior Survey of Nebraska

CURRENT TRENDS ADOLESCENT ADDICTION

26% of youth have their first drink of alcohol before the age of 13.

28% of all fatal alcohol related motor vehicle accidents involve youth between 15 –20.

Alcohol is a major factor in 50% of all motor vehicle accidents, homicides, and suicides among youth.

ADOLESCENT ADDICTIONJuvenile Justice Link

83 % of youth involved with the Juvenile Justice System have alcohol and drug use problems.

Inhalant Use is more common in this group…

Substance Abuse Prevalence Data Based on Nebraska 1999 Census

NEED Likely to Demand Services

Likely to Demand Specialty Services

ADULT: Mental Health

(Unduplicated) % Number % Number

Diagnosed Mental Disorders

83,394 20% 16,679 37% 6,171

Serious Mental Illness 12,041 40% 4,816 50% 2,408

Diagnosed SPMI 9,009 70% 6,306 76% 4,793

Disabled by SPMI 3,032 90% 2,729 93% 2,538

TOTAL ADULTS - MH

107,476 28% 30,093 53.9% 15,910

ADULT Substance Abuse

32,555 20% 6,511 20% 1,302

TOTAL Behavioral Health – Adults

140,030 26.1% 36,604 47.7% 17,212

Substance Abuse Prevalence Data Based on Nebraska 1999 Census

ADULTS Co-Occurring MH & SA

Estimated Need

Co-Occurrence by Level of Mental

Disorder

% Likely to Demand Specialty Services

Diagnosable Mental Disorder 83,394 11.6% 9,674 37% 3,579

Serious Mental Illness 12,041 19.3% 2,324 50% 1,162

SPMI 9,009 25.9% 2,333 76% 1,773

Disable by SPMI 3,032 33.3% 1,010 93% 939

Total Co-Occurring MH/SA 107,476 14.3% 15,341 52.9% 7,455

Estimated Region VI – Adults with Co-Occurring Disorders (38.8%)

41,701   5,952   2,893

ADDICTIONCo-Occurring Disorders

Substance Abuse combined with Mental Illness, occurs in 70% of those addicted.

The presence of co-occurring disorders reduces the responsiveness to treatment.

There is serious risk of missing a co-occurring disorder because the symptoms are ‘masked’ by the substance use.

HomelessHomeless

National: 2,000,000

Nebraska: 9,280

Nebraska HomelessNebraska Homeless

1.0%

10.2% 6.1%

24.7% 7.5%

22.7%

8.3%

SPMI

AOD

Dual Diagnosis

Domestic Violence

AIDS/Related

Youth

Migrant Workers

FAMILY MATTERSThe Effects of Addiction on the Family

U.S. Dept. of Health & Human Services: 10 million untreated persons in 2000 3 million received treatment in 2000

Addiction is one of the families most guarded secrets.

Co-Dependency: Condition characterized by preoccupation and extreme dependency (emotional, social & physical) on a person or object. This becomes pathological.

FAMILY MATTERSThe Effects of Addiction on the Family

FAMILY ROLES: Dependent Enabler Hero Scapegoat Lost Child Mascot

FAMILY MATTERSThe Effects of Addiction on the Family

FAMILY MATTERSThe Effects of Addiction on the Family

FAMILY SYSTEMS: All members assume specific roles & relate to each

other in characteristic ways. The roles that family members adopt & how they

relate to each other operate according to “rules”. Roles and patterns constitute equilibrium.

Any shifts in family equilibrium will cause resistance & system will seek a return to equilibrium.

No matter how sick/abnormal it may appear, the established equilibrium represents the family’s attempt to minimize threat of pain & disruption

FAMILY MATTERSThe Effects of Addiction on the Family

THE FAMILY SECRET ?

Family requires intervention… all have affected, all need treatment!

ADDICTIONGRIEF REACTION

Grief is at the core of the recovery process. Much like the death or ending of a long-term relationship, the addicted individual has a committed, love relationship with their chemical, person, thing, and the discontinuation of this relationship causes a significant and very real experience of loss.

ADDICTION5 STAGES OF GRIEF

Denial & IsolationAngerBargainingDepressionAcceptance

ADDICTIONTREATMENT

Philosophical Approach:HolisticFamily Systems OrientedDevelopmentally Based

Treatment Components:Comprehensive AssessmentPlan of treatment based on the development

strengths and needs of the adolescent, as well as the family strengths and needs.

Crisis Services:

• Medically Monitored Detoxification

• Civil /Emergency Protective Custody

Treatment Services:

• Outpatient Treatment

• Intensive Outpatient

• Short Term Residential

Transitional Services:

• Intermediate Residential

• Halfway House

Prevention & Education Services:

• Community Support

• Post Primary Group

• Correctional Services

• Alumni Association