SOC 204 Drugs & Society

Chapter 15 Substance Abuse TreatmentGoldberg

Attendance:How are you doing?

A. Doing GREAT!B. OkayC. Feeling stressed

Doing GREA

T!Okay

Feelin

g stre

ssed

0% 0%0%

Treatment Video

http://digital.films.com/PortalViewVideo.aspx?xtid=30382

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.

Administrative

stru

cture

.

Training r

equirements.

Goals.

Theoretica

l appro

ach.

0% 0%

96%

4%

Opinion: What do you think

the goal of treatment should

be?A. Complete

abstinenceB. Controlled

substance useC. Helping the user

make better decisions

D. Other Complete abstinence

Controlle

d substa

nce use

Helping the use

r make be...

Other

29%

0%

71%

0%

Stages of Change

• Motivational Enhancement Interview• Resistance

• Client• Community

The goal of motivational

enhancement is1. 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 use

r with

...

Find alte

rnatives t

o subs..

.

Encoura

ge th

e user t

o m...

14%

81%

5%

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 Modalities

• Detox

• Inpatient

• Outpatient

• Therapeutic Communities

• Self-Help Groups

• Methadone Maintenance

Treatment Components

• Contingency Management

• Cognitive Behavioral Therapy (CBT)• Individual, group, family

• Pharmacotherapies

• Detoxification

• Maintenance

The most widely used

treatment for substance abuse

is:A. Motivational

enhancementB. Pharmacotherap

yC. Cognitive-

behavioral therapy

D. DetoxificationM

otivational enhance

ment

Pharmaco

thera

py

Cognitive

-behaviora

l the...

Detoxifica

tion

0% 0%

91%

9%

The goal of the maintenance

phase of treatment is

A. Preventing seizures

B. Preventing cross tolerance

C. Preventing relapse

Preventing seizu

res

Preventing cro

ss to

lerance

Preventing relapse

0%

100%

0%

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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

Treatment Issues

• Four pertinent issues in treating drug abuse:1. Voluntary or compulsory treatment2. Matching patients to the best

treatment3. 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