Substance Abuse Therapy

Substance Abuse Therapy Techniques & Guide

Substance Abuse Therapy Definition:
Substance abuse, also known as drug abuse, is a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect.

Public health practitioners have attempted to look at drug abuse from a broader perspective than the individual, emphasizing the role of society, culture and availability. Rather than accepting the loaded terms alcohol or drug "abuse," many public health professionals have adopted phrases such as "substance and alcohol type problems" or "harmful/ problematic use" of drugs.

The Health Officers Council of British Columbia — in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada — has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms "use" vs. "abuse". This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic.

In the modern medical profession, the two most used diagnostic tools in the world, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD), no longer recognize 'drug abuse' as a current medical diagnosis. Instead, DSM has adopted substance abuse as a blanket term to include drug abuse and other things.

ICD refrains from using either "substance abuse" or "drug abuse", instead using the term "harmful use" to cover physical or psychological harm to the user from use. Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the Diagnostic and Statistical Manual of Mental Disorders.

"Substance dependence When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. These, along with Substance Abuse are considered Substance Use Disorders."

Know More about Substance Abuse Theory:
Drug misuse is a term used commonly for prescription medications with clinical efficacy but abuse potential and known adverse effects linked to improper use, such as psychiatric medications with sedative, anxiolytic, analgesic, or stimulant properties. Prescription misuse has been variably and inconsistently defined based on drug prescription status, the uses that occur without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of abuse or dependence symptoms.

As its name implies, the primary concern is with the cognitive abilities and skills of the client. The cognitive therapies are directed towards identifying and correcting maladaptive thinking patterns that result in self-defeating or self-destructive behaviors and feelings. The goal of therapy is to assist the client in mastering skills used to identify problems, evaluating his/her perspectives concerning the problems, and providing a more balanced perspective that is conducive to more productive behaviors. This is accomplished by approaching problem solving in a systematic manner composed of steps that the client perceives as being manageable. Cognitive therapy is usually directed towards enhancing the coping capabilities of the patient.

Problem focused strategies or emotional focused strategies are the two primary approaches used in cognitive therapies to create a shift in thinking which transforms the client's perception of the problem. Problem focused strategies are useful in directing the client to identify a specific problem. The client is then assisted in identifying the responses that are typically used to reduce distress in the situation and to evaluate those responses for effectiveness. Alternative responses are then developed and examined from a cost-benefit perspective empowering the patient to make conscious choices about how he/she chooses to respond to stressful situations. This empowerment lends the patient a sense of control, as heretofore-unrecognized options become viable alternatives in managing distress.

Emotional focused strategies achieve the same end as the problem-focused strategies but from a different means. In this technique, the client's perception of the distressful event is altered, thereby causing a subsequent change in level of perceived distress. By redefining the problem, the patient can hold the power to transform a crisis into an opportunity or challenge. This re-framing of the event can be accomplished by minimization, distancing, selective attention, and searching for positive value from a bad situation. Ultimately, the result is that the patient has an increased sense of control over the situation and therefore stress is reduced.

Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.

There is a high rate of suicide in alcoholics and drug abusers. The reasons believed to cause the increased risk of suicide include the long-term abuse of alcohol and drugs causing physiological distortion of brain chemistry as well as the social isolation. Another factor is the acute intoxicating effects of the drugs may make suicide more likely to occur.
Suicide is also very common in adolescent alcohol abusers, with 1 in 4 suicides in adolescents being related to alcohol abuse. In the USA approximately 30 percent of suicides are related to alcohol abuse. Alcohol abuse is also associated with increased risks of committing criminal offences including child abuse, domestic violence, rapes, burglaries and assaults.

Symptoms:
1. Drug abuse, including alcohol and prescription drugs can induce symptomatology which resembles mental illness. This can occur both in the intoxicated state and also during the withdrawal state.

2. In some cases these substance induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. A protracted withdrawal syndrome can also occur with symptoms persisting for months after cessation of use.

3. Severe anxiety and depression are commonly induced by sustained alcohol abuse which in most cases abates with prolonged abstinence. Even moderate alcohol sustained use may increase anxiety and depression levels in some individuals. In most cases these drug induced psychiatric disorders fade away with prolonged abstinence.

4. Drug abuse makes central nervous system (CNS) effects, which produce changes in mood, levels of awareness or perceptions and sensations. Most of these drugs also alter systems other than the CNS. Some of these are often thought of as being abused. Some drugs appear to be more likely to lead to uncontrolled use than others.

5. Naltrexone, a drug originally marketed under the name "ReVia," and now marketed in intramuscular formulation as "Vivitrol" or in oral formulation as a generic, is a medication approved for the treatment of alcohol dependence. This drug has reached very few patients. This may be due to a number of factors, including resistance by Addiction Medicine specialists and lack of resources.

6. The ability to recognize the signs of drug use or the symptoms of drug use in family members by parents and spouses has been affected significantly by the emergence of home drug test technology which helps identify recent use of common street and prescription drugs with near lab quality accuracy.


Causes:
In 2009 in the United States about 20% of high school students have taken prescription drugs without a prescription.

1 in 5 teenagers report having abused a prescription medication and over 2500 teenagers a day experiment with prescription medications taken from the home.

Most physicians and pharmacists advise patients to securely lock up their medications, hoping to prevent access to prescription medications by toddlers and teenagers.


History:
In the first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (published in 1952) grouped alcohol and drug abuse under Sociopathic Personality Disturbances, which were thought to be symptoms of deeper psychological disorders or moral weakness.

The third edition, published in 1980, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasized tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tolerance.

In 1987 the DSM-IIIR category "psychoactive substance abuse", which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous". It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioral and physiological factors in diagnosis.

By 1988, the DSM-IV defines substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal". Substance abuse can be harmful to your health and may even be deadly in certain scenarios.

By 1994, The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association ,the DSM-IV-TR, defines substance dependence as "when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed." followed by criteria for the diagnose.

So, by this time the was a proper & perfect definition formed for this effect & then all the medications were taken into account with regards to this definition.


Effects on the people:
• A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)

2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)

4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

• B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

After all of this delay & reconstruction the legal authorities also were put to force to avoid this problem & Drug control law, Prohibition (drugs), Arguments for and against drug prohibition were put in force.


The effects of such implementations were as follows:
Most governments have designed legislation to criminalize certain types of drug use. These drugs are often called "illegal drugs" but generally what are illegal are their unlicensed production, distribution, and possession. These drugs are also called "controlled substances". Even for simple possession, legal punishment can be quite severe (including the death penalty in some countries). Laws vary across countries, and even within them, and have fluctuated widely throughout history.

Attempts by government-sponsored drug control policy to interdict drug supply and eliminate drug abuse have been largely unsuccessful. In spite of the huge efforts by the U.S., drug supply and purity has reached an all time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health.

In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens.

Despite drug legislation (or perhaps because of it), large, organized criminal drug cartels operate worldwide. Advocates of decriminalization argue that drug prohibition makes drug dealing a lucrative business, leading too much of the associated criminal activity.


Treatment:
Treatment for binge drinking and other forms of substance abuse is critical for many around the world. Behavior interventions do exist that have helped people to restore some sanity to their lives. From the applied behavior analysis literature and the behavioral psychology literature several evidenced based intervention programs have emerged:

In addition, it is suggested that social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious. However, these programs are not wide spread amongst addiction counselors. Recent trends by NIDA have been to help deploy these intervention techniques. Several successful programs are underway


Summary:
Substance abuse is not a simple cause and effect relationship. Instead, it involves a myriad of factors, both internal and external to the patient, which contribute to use, abstinence, and relapse prevention. For the addicted person, all of life is affected by the need to obtain and use his/her drug of choice.

Relationships with family members, coworkers, social groups, and the self can be seriously compromised. In large part, these effects are the result of subconscious or conscious thoughts that precipitate detrimental behaviors. Cognitive based therapies provide a fertile field for dealing with these issues. By enhancing the client's awareness of the cognitions that lead to these behaviors, it becomes possible to open the way for learning new ways of thinking about situations. This effectively empowers to client to make choices about behaviors that are more conducive to the way he/she wishes to live life.

Once the deeply entrenched values and beliefs have been uprooted, the client can begin to develop new ways of approaching challenges that are less costly and provide greater benefits in quality of life than the previous ones were capable of contributing.

In light of the recent trends towards managed care, cognitive therapies offer a cost-effective alternative because it can be used effectively with any age group and as a short-term intervention. It also allows for the treatment of co morbid mental health issues within the same treatment venue. Once the client has mastered the methods employed, they can be applied to a broad range of areas of life where distress occurs. Thus, the client is empowered with problem-solving techniques.

The mental health provider must maintain an awareness of the potential complications in cognitive functioning that are likely to accompany substance abuse issues. Before a period of abstinence from the chemical substance, there may be cognitive side effects that may change as usage decreases or ceases. The length of time and the degree of change that occurs can be a function of the type of substance abuse and the length of time of usage.

Furthermore, it is likely that the substance abuser has developed self-care patterns that can also affect cognitive functioning. Dietary intake, poly-substance abuse, stress, and physical illnesses can all serve to reduce cognitive functioning. Some of these deficits may reverse when the behaviors causing them change. Unfortunately, there are also situations where the damage is irreversible. This clearly mandates the care provider to do an ongoing assessment of the unique individual in order to maximize the benefits of cognitively based therapeutic interventions.

About the Author: Rohit Gala Is Passionate about helping people till all the people are finally happy & that is why he has joined this counseling course to know people & solve their problems faster. He also likes playing games like Shot- put, javelin throw & Chess. He is a BMS Graduate in finance. He also Like to work hard until the work is done & believes in the thought “It does not matter if you don’t know how to do a thing, but what matter is your craze & your feelings attached to that job to finish it before time.”

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