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Effective Treatment of Substance Use Disorders and Trauma in Older Adults: Clinical and Spiritual Perspectives Dr. Kenneth Chance, D. Div. Mr. Robert Potter, M.A., LISAC, CSAT October 19, 2016

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Effective Treatment of

Substance Use Disorders and Trauma in Older Adults:

Clinical and Spiritual Perspectives

Dr. Kenneth Chance, D. Div.

Mr. Robert Potter, M.A., LISAC, CSAT

October 19, 2016

Thomas Durham, PhD

Director of Training

NAADAC, the Association for

Addiction Professionals

www.naadac.org

[email protected]

Produced By

NAADAC, the Association for Addiction Professionalswww.naadac.org/webinars

www.naadac.org/webinars

www.naadac.org/SUDandtraumaforolderadults

Cost to Watch:

Free

CE Hours

Available:

1 CEH

CE Certificate

for NAADAC

Members:

Free

CE Certificate

for Non-

members:

$15

To obtain a CE Certificate for the time you spent

watching this webinar:

1. Watch and listen to this entire webinar.

2. Pass the online CE quiz, which is posted at

www.naadac.org/SUDandtraumaforolderadults

3. If applicable, submit payment for CE certificate

or join NAADAC.

4. A CE certificate will be emailed to you within 21

days of submitting the quiz.

CE Certificate

Using GoToWebinar – (Live Participants Only)

Control Panel

Asking Questions

Audio (phone

preferred)

Polling Questions

Ken Chance, D. Div. Bob Potter, LASAC, CSAT

Webinar

Presenters

Your

arrowheadlodgerecovery.com

“There’s got to be more to life

than fighting for fish heads!”

Jonathan Livingston Seagull

The wound is the

place

where Light

enters you.

Webinar Learning Objectives

1 321. Consider a hypothesis about why many older adults relapse after

multiple attempts at treatment.

2. Gain greater awareness of the challenges of treating older

adults diagnosed with SUD’s and trauma co-morbidities.

3. Identify typical symptoms and chief complaints reported by older

adults who suffer from SUD and trauma.

1 324. See the similarities in the neuroscience of addiction and trauma.

• What occurs in the brain during trauma.

• What occurs in the brain in active addiction.

5. Understand the clinical and spiritual benefits of mindfulness

and meditation.

6. Learn why a spiritual awareness of one’s Authentic Self is vital

for long-term recovery.

Webinar Learning Objectives

Some Stats

U.S. population 65+

2014 - 14.5%

2040 - 22%

2060 - 30%

U.S. Department of Health and Human Services - Administration on Aging (AoA)

Some Stats

• 6-11% of all elderly patients admitted to hospitals

exhibit symptoms of alcoholism

• 14% of all elderly patients in ER exhibit symptoms of

alcoholism

• Problem drinking in nursing homes is as high as 49% in

some studies

NCADD: An Invisible Epidemic: Alcoholism and Drug Dependence Among Older Adults

Some Stats

• 17% (8 million) older adults abuse alcohol and

drugs - SAMHSA

• Less than 2% of all admissions for alcohol and drug

treatment are people over age 55

• Illicit drug use among seniors is projected to double

by 2020 to 3.5 million

NCADD: An Invisible Epidemic: Alcoholism and Drug Dependence Among Older Adults

Co-morbid PTSD and SUD Clients

• Greater difficulty maintaining sobriety

• Increased difficulty in healing traumatic memories.

(Ford, Hawke, Alessi, Ledgerwood & Petry, 2007; Peirce, Kindbom, Waesche, Yuscavage, & Brooner,

2008; Schumacher, Coffey& Stasiewicz, 2006)

Clients with PTSD

Men Women

#1

Alcohol abuse/dependence

#1

Depressive Disorders

#2

Depressive Disorders

#2

Anxiety Disorders

#3

Anxiety Disorders

#3

Alcohol abuse/dependence

(American Journal of Psychiatry: “Substance use disorders in patients with PTSD:

a review of the literature” (Jacobsen, Southwick and Kosten)

Clients with PTSD

Men Women

#1

Alcohol abuse/dependence

#1

Depressive Disorders

#2

Depressive Disorders

#2

Anxiety Disorders

#3

Anxiety Disorders

#3

Alcohol abuse/dependence

(American Journal of Psychiatry: “Substance use disorders in patients with PTSD:

a review of the literature” (Jacobsen, Southwick and Kosten)

Clients with PTSD

Men Women

#1

Alcohol abuse/dependence

#1

Depressive Disorders

#2

Depressive Disorders

#2

Anxiety Disorders

#3

Anxiety Disorders

#3

Alcohol abuse/dependence

(American Journal of Psychiatry: “Substance use disorders in patients with PTSD:

a review of the literature” (Jacobsen, Southwick and Kosten)

Addiction + Trauma + Older Adults

Suicide Among Adults Aged 50–59

Years

US, 1999–2010

0

5

10

15

20

25

30

35

Men 50 - 54 Women 50 - 54 Men 55 - 59 Women 55 - 59

1999 2010

CDC Morbidity and Mortality Weekly Report, May 3, 2013 / 62(17); 321-325

Typical Case Study

Married

Career with some

success

Children

Typical Case Study

Compliant

Polite

Easy to like

Smiles a lot

Typical Case Study

“I got this!”

Typical Case Study

Drank X days post D/C

WHY?

Typical Answers

Typical Answers

He/she didn’t “get it” the first time…

Typical Answers

He/she didn’t do a thorough 1st. Step…

Typical Answers

He/she didn’t participate in group…

Typical Answers

He/she didn’t get a Higher Power…

Typical Answers

He/she didn’t get a Higher Power…

What Did I Miss?

It’s What He Didn’t and Won’t Talk About

Fathers of Baby-Boomers

Look at Their Affects

Sense any Happiness/Joy?

How Did They Parent?

Generational Trauma

Deeply Engrained Secret

Challenges with Older Adults

Old ideas and

stereotypes…

Emotionally disconnected…

Communication…

Therapeutic alliance…

The difficulty lies not so

much in developing new

ideas as in escaping from

old ones.

John Maynard Keynes

Old Ideas - Generational Differences

Old Ideas - Generational Differences

Old Ideas - Generational Differences

Gender Stereotypes

Gender Stereotypes

Emotionally Disconnected

Emotionally Disconnected

The worst type of pain is when you are

smiling, just to hold back the tears.

Unkown

Communication

Me, me, me,

me, me*#!^@

Communication – with One Another

Communication with Counselor

Therapeutic Alliance

Older Adults Want to Know their Therapist is Credentialed

Therapeutic Alliance - Safety & Trust

“I’m not

going to tell

him/her

about that

stuff”

Assessments – What to Look For

Typical Complaints/Symptoms

Cycle of Addiction and Trauma

Neuroscience Addiction & Trauma

Neuroscience 101

Neuroscience 101

What Happens in Early Childhood Trauma

Why one reacts with emotion such as angry outbursts rage

terror fear and the like.

Lights up during

a traumatic

experience as

well as during

recall or

flashback.

Does not

process/sequenc

e the traumatic

experience.

Bessel Van Der Kolk, M.D.

What Happens in Early Childhood Trauma

Bessel Van Der Kolk, M.D.

Why talk therapy is so often ineffective in resolving

trauma.

The emotional

and somatic

experience is

stored in the

right hemisphere

Talk therapy uses

left hemisphere

Brain Attempts at Resolution

The brain constantly

attempts to organize the

chaotic mess of trauma

and presents either in

autoimmune syndromes

accidents and

attachments.

Bessel Van Der Kolk, M.D.

Stress Response

Fear

Why They Can’t Remember Trauma

Typical Complaints/Symptoms

Drugs and the Brain

Drugs and the Brain

Regulation

Mindfulness and the Brain

Mindfulness and the Brain

Mindfulness and the Brain

Mindfulness and 4 Areas of Behavior

Meditation and the Brain

Mindfulness Helps Change Old Habits

Mindfulness & Meditation

Mindfulness & Spirituality

Mindfulness & Spirituality

Mindfulness

Awareness of thoughts, emotions and behavior:

• To consider how what I think, feel and act might impact,

positively or negatively, others.

• To develop compassion and empathy for others.

• To practice humility through gratefulness.

• To consciously establish one’s intent before initiating action.

• To become more compassionate in my relationships.

• To observe chaos rather than create it.

• To respond rather than react.

• To allow space before one chooses.

214 mph

Spirituality Means:

Ultimately spiritual awareness unfolds

when you’re flexible,

when you’re spontaneous, when you’re

detached,

when you’re easy on yourself

and easy on others.

Deepak Chopra

Thank You!

Your

Ken Chance, D. Div.

928-227-2448, ext. [email protected]

Bob Potter, M.A., LASAC, CSAT

928-227-2448, ext. [email protected]

arrowheadlodgerecovery.com

www.naadac.org/SUDandtraumaforolderadults

Cost to Watch:

Free

CE Hours

Available:

1 CEH

CE Certificate

for NAADAC

Members:

Free

CE Certificate

for Non-

members:

$15

To obtain a CE Certificate for the time you spent

watching this webinar:

1. Watch and listen to this entire webinar.

2. Pass the online CE quiz, which is posted at

www.naadac.org/SUDandtraumaforolderadults

3. If applicable, submit payment for CE certificate

or join NAADAC.

4. A CE certificate will be emailed to you within 21

days of submitting the quiz.

CE Certificate

Adolescent Development and Susceptibility

of Teens Toward Addiction

By Beth Donnellan

December 7, 2016

November 16, 2016 December 21, 2016

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