TRENDS IN CHEMICAL DEPENDENCY TREATMENTCoralee Goni, MS, MBA, MAC

Rimrock Foundation

RIMROCK FOUNDATION

Montana’s oldest and largest Addiction Treatment Facility- 1968 – Billings, MT.

Care is delivered through multiple levelsof Service:Medical DetoxificationMedically Monitored InpatientPartial HospitalizationResidential Intensive Outpatient TreatmentCommunity-based Sober Housing

ADVANCED INTEGRATED MODEL OF ADDICTION TREATMENT

Psychological dependency — an irrational belief in and reliance on mood-altering chemicals or experiences for the purpose of achieving welcomed changes in moods and feeling states.

Mental obsession — an intense, uncontrollable preoccupation with the anticipated changes in moods and feeling states that will occur with the drug or activity.

Emotional compulsion — an intense, emotional impulsiveness to obtain the immediate gratification produced by a chemical or activity.

Length of treatment is directly correlated to lasting reductions in criminal activity

Greatest reductions are seen in those who complete a full continuum of care

90+ Days

LENGTH OF TREATMENT

4

Purpose of treatment Break old patterns of thinking and behaving Learn new skills for avoiding drug use and

criminal behavior Replacing drug use and criminal activities with

constructive activities Understanding consequences“Hey, you can’t pin my problems on drugs. I wasn’t

high when I was caught stealing a case of beer. I wasn’t fiending for alcohol. I just liked the thrill of stealing and getting away with something…Now

I’m locked up for 30 days.” --Jordan, 17

TREATMENT

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Effective treatment will take into accountDifferences in age, gender, ethnicity,

and cultureDifferences in problem severity and

recovery stageDifferent treatment approaches

should be utilizedFacilitate healthy relationships

Family, peers, and others in the community

INDIVIDUALIZED TREATMENT

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High rates of mental health problems are found in both Offender Populations and Substance Abuse Populations

Treatment should address Depression Anxiety Other identified mental health concerns

Medications Typically need longer treatment (minimum of

3 months)

INTEGRATED TREATMENT

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Triggers for relapseStressAssociations with using peersSocial situations linked to drug use

Collaboration between probation officers and treatment providers is essential to effective monitoring of recovery

“Sometimes I have failed. But I am not a failure; I have made mistakes, but I am

not a mistake.” –AA Booklet

DRUG USE DURING TREATMENT

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Depends… On the individual On the treatment provider

Treatment must address: Attitudes, Behaviors and Beliefs

Outcome studies show that those who participate in drug abuse treatment programs commit

fewer crimes than those who do not participate.

HOW EFFECTIVE IS TREATMENT FOR CRIMINAL JUSTICE-INVOLVED INDIVIDUALS?

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Determining appropriate level of care is essential to meeting the needs of the client

Low motivation for treatment should not deter access to treatment.

Legal pressure for treatment encourages participation, abstinence and improves retention.

ARE ALL DRUG ABUSERS IN THE CRIMINAL JUSTICE SYSTEM GOOD CANDIDATES FOR TREATMENT?

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YES!!

IS LEGALLY MANDATED TREATMENT EFFECTIVE?

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Problems contributing to relapse Family difficulties Limited social skills (Involvement with peers) Educational and employment problems Mental heath disorders Stress

WHAT ARE THE RELAPSE AND RISK FACTORS FOR CRIMINAL OFFENDERS

WHO COMPLETE TREATMENT?

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Source: S

ubstance Abuse M

ental Health A

ssociation, ww

w.S

AM

HS

A.gov

TREATMENT AND TREATMENT NEED

Qualify for tx, but felt they did not

need tx95%

Felt they needed treatment and did not make an effort

3%

Felt they needed treatment and Did

make an Effort1%

Source: S

ubstance Abuse M

ental Health A

ssociation, ww

w.S

AM

HS

A.gov

REASONS FOR NOT SEEKING TREATMENT

NATIONAL TRENDS

Source: S

ubstance Abuse M

ental Health A

ssociation, ww

w.S

AM

HS

A.gov

2011 DRUG USE

Mari-juana58%

Co-caine8%

Opiates21%

Meth2%

In-halants

3%

Hallucinogen8%

Source: S

ubstance Abuse M

ental Health A

ssociation, ww

w.S

AM

HS

A.gov

NATIONALLY…

In 2011, marijuana was the most commonly used illicit drug, with 18.1 million current users. (14.5 million in 2007)

Used by 80.5 percent of current drug users. (64% of all drug users ONLY use marijuana.)

Source: S

ubstance Abuse M

ental Health A

ssociation, ww

w.S

AM

HS

A.gov

8.0 million people aged 12 or older were current users of drugs other than marijuana in 2011.

6.1 million of those persons were nonmedical users of psychotherapeutic drugs, including: 4.5 million users of pain relievers 1.8 million users of tranquilizers 970,000 users of stimulants 231,000 users of sedatives.

Source: S

ubstance Abuse M

ental Health A

ssociation, ww

w.S

AM

HS

A.gov

ILLICIT DRUG DEPENDENCE OR ABUSE IN THE PAST YEAR AMONG PERSONS AGED 12

OR OLDER

Source: S

ubstance Abuse M

ental Health A

ssociation, ww

w.S

AM

HS

A.gov

SPECIFIC ILLICIT DRUG DEPENDENCE OR ABUSE IN THE PAST YEAR AMONG PERSONS

AGED 12 OR OLDER: 2011

CONCLUSION Watching trends

Marijuana Pain Relievers Process addictions

Synthetic Drugs Spice Bathsalts