Substance Abuse Prevention Facts About Substance Abuse Alcoholism is considered the third most...

Substance Abuse PreventionSubstance Abuse Prevention

Facts About Substance Abuse

Alcoholism is considered the third most prevalent public health problem in the United States today.

It is estimated that 32 million Americans smoked marijuana in the last year. 20 million use it monthly. Approximately 12 million use cocaine yearly.

Approximately 40% of hospital admissions and 25% of deaths each year are related to substance abuse.

Approximately ½ of all traffic fatalities involve alcohol.

“Copyright © Allyn & Bacon 2004”


Considerations For Clients With Substance Abuse Problems

Diagnosis: Substance abuse or substance dependence?

Special Treatment Issues: Substance abuse problems exist on a continuum. Treatment plans should be individualized, multidimensional, un-intrusive and sensitive to diversity issues.

Counseling goals: Abstinence or controlled use?



Treatment Strategies For Clients With Substance Abuse Problems

The Minnesota Model: A comprehensive treatment team does an analysis, followed by a 28-day inpatient hospitalization.

Alcoholics Anonymous Model: Incorporates the disease model and advocates for abstinence. Uses the 12-steps and has a strong spiritual component.

The Medical Model: Also adheres to the disease model, uses medical approaches (e.g. antibuse, methadone and detoxification), and believes there are biological components to addiction.



Treatment Strategies For Clients With Substance Abuse Problems (continued)

Cognitive-Behavioral Therapies: Helps clients develop the skills to deal with their addictions (e.g. self-control, coping mechanisms, relapse prevention.)

Behavioral Therapies: Operant conditioning (reward and punishment), systematic desensitization and aversion training.

Individual Psychodynamic/Interpersonal Therapies: Formulation of the counseling relationship and skill development.



Treatment Strategies For Clients With Substance Abuse Problems (continued)

Group Therapies: Gives support and encouragement and generates problem-solving strategies.

Family Therapy: Some feel family therapy is necessary as the addiction affects the family and the family affects the addiction.



Stages of Change

Precontemplation: Clients are resistant and deny they have a problem.

Contemplation: Clients are aware they have a problem and are actively wondering what they should do about it.

Preparation: Client have taken some action, were unsuccessful, but plan to try again.

Action: Clients are taking action and are making changes.

Maintenance: Efforts are on relapse prevention.



Relapse Prevention

It is estimated that 90% of all clients have a relapse within four years of treatment.

Factors that influence: Comorbidity and changes or stressors in lifestyle.

Preventative factors: Coping mechanisms and self-efficacy.



The Counseling Process

Develop trust

Assess the problem

Establish goals

Implement a plan

Train for relapse avoidance or minimization

Termination



The Counseling Process (continued)

Structuring the Sessions: Most counselors provide strict guidelines (e.g. come straight; do homework etc.)

Assessment: Examples of questions that need to be answered are:– How significant is the problem?– How long has the client been a user?– Has the client tried to stop?– Does the client have a another disorder?– How has the client been functioning socially?




Goal Setting: It is usually either abstinence or controlled use. It might also include intrapersonal change, behavioral change or lifestyle change.

Plan Implementation: Before plan implementation, detoxify if needed. Otherwise implement the plan to meet goals (e.g. AA or antibuse).




Relapse Prevention: Relapses are most likely to occur within six months. Help the client become aware of what his or her triggers for relapse are and develop a plan to deal with these.

Termination: Termination occurs when both counselor and client feel the client can cope without the substance.


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