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Cravings are different from wants and desires. They are stickier.
Understanding and treating addiction requires an understanding of what cravings are and how they work. Helping someone overcome and recovery from addiction is not about helping them stop using. I believe it is important to help our clients understand the difference between wants, desires, and cravings. This is a great article addressing this issue.
How Substance Abuse Starts
Contributor: Yvette McBride Thomas
There is a debate in this country about how substance abuse begins. In the past, it was believed to be a moral issue. At that time, alcoholics and addicts were seen as morally deficient. This is not the view of clinicians today. Today physicians, psychologists, and counselors identify chemical dependency as a disease. The question still remains, however: why can some people use alcohol or drugs safely while others become chemically dependent? The debate points to heredity or environment, or a combination of these. Many experts theorize that chemical dependency is hereditary. If we examine the background of someone who is alcohol- or drug-dependent, we often see a family history of the illness. One thing is certain: in order to become chemically dependent, an individual must first begin using alcohol or drugs. As mentioned previously, the United States, though comprising only 5-6% of the world’s population, consumes three-quarters of all illegal drugs produced in the world! Additionally, Americans are the leading abusers of alcohol and prescription drugs in the world. Why is this?
One environmental theory is based on the fact that American society today over-emphasizes the importance of “feeling good.” In our society, if a person doesn’t feel well, we
reach for substances as a solution. As a result, our society has developed a “pill for every ill” attitude. These “ills,” regardless of type or severity, are often being treated with drugs or alcohol. Our “pill-for-every-ill” attitude influences many individuals in our society to believe that a chemical cure is the only solution for any societal problem. (We’re not referring here to the appropriate use of medication, as prescribed by a physician or other health care professional, for physical, mental, or emotional disorders, but rather to the abuse of alcohol and drugs.)
As adults, we demonstrate this “pill for every ill’ attitude to our children. We may take pills to get started in the morning, to get to sleep at night, to deal with mild pain, or to deal with situational sadness. This vicious cycle of chemical cures is paraded in front of our children on a daily basis. This behavior does not provide a proper example for our children. Today, the morals we teach our children have changed. Unfortunately, the breakdown in discipline of children and the many changes in family structure (such as families where both parents work, single-parenting situations, etc.) have eroded the traditional family structure. It is often replaced with a loose structure, in which children may doubt their parents’ authority and values.
Community is another area where society has weakened. Changes in the community have contributed to a breakdown, a lack of respect, in the general moral standards of the past. We live in a society where “anything goes.” Often, there are no repercussions when moral standards or laws are broken. Looking at our society, we see gang wars, prostitution, drug trafficking and theft. Many people do not know who their neighbors are and have little concern for them. Children are being taught (by the example of the adults in their lives) to “look the other way,” and to avoid confronting important issues.
Drugs are in our children’s lives at an early age. Often children face major decisions before they are twelve years old as to whether or not to smoke, drink or use drugs. Because of this, information about alcohol, drugs and appropriate decision making must be presented early by knowledgeable individuals in the school system. This education of our youth should not stop with the school system but should be reinforced in the home, in athletics, in the workplace and in the community.
Childhood and adolescence is a time of tremendous change in a child’s life. Teens, in particular, undergo rapid changes in emotions, coinciding with the numerous physiological changes taking place. This is also the age at which a child begins to create his/her own value system. It is very important for parents to understand that substance use by children and teens is a very critical issue. Substance abuse affects a young person’s emotional, physical, and moral development. It contributes to emotional immaturity, improper physical development, poor moral standards, an inability to learn and faulty decision making. But we must start setting the right example even before the teen years. For pre-school age children and toddlers, parents should reinforce the concept that medicine is taken only for illnesses or by direction of a physician. Drug education in primary schools is extremely important. Teachers, administrators and parents should all provide educational information to the children and reinforce the consequences associated with substance use.
Substance abuse is on the rise by our adolescents. During the teenage years, experimentation with alcohol and/or drugs is common; this is when most drug problems begin. Most people are unaware that alcohol is classified as a mood-altering drug. Use of alcohol by teenagers often leads to use of other drugs. Experimentation with substances may occur in the home, at school, in social situations or at a stressful time in youngsters’ lives. Alcohol and drugs are used on a regular basis by a large percentage of our teenagers, many of whom later become alcoholics or drug addicts. Sadly, we know that some will even die as a result of their substance use.
Today, an alarming number of adolescents are smoking cigarettes. Once they begin using tobacco, marijuana is the logical next step. Over half of adolescents admitted to drug treatment programs are seeking treatment for marijuana addiction. Adolescents who smoke marijuana are 85 times more likely to eventually turn to cocaine and other “hard” drugs, compared to those who have not smoked marijuana. Thus, tobacco, alcohol, and marijuana are known as “gateway” drugs. Use of these “gateway” substances may lead to “harder” drugs, especially for adolescents who are already chemically dependent upon alcohol or marijuana.
Once our children become adults, the cycle doesn’t end. As adults, they become part of our nation’s workforce. In our corporations today, we see many problems caused by substance abuse. The list is staggering: increased absenteeism and illness, lower productivity, theft, an increased number of accidents and fatalities, greater use of medical benefits, violence, altercations, and lower employee morale are all related to drug and alcohol abuse in the workplace.
To combat experimentation and substance abuse, all aspects of society must join together and provide educational information to our children on the dangers of substance use. We must be good role models. We must provide community support, and encourage effective law-enforcement programs. We must arm our youth with the knowledge they need to make important decisions about alcohol and drug use.
Reasons for Using Substances
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Related articles
- Do You Have a Substance Abuse Problem? (everydayhealth.com)
- Depression and Substance Abuse (everydayhealth.com)
- Treating Substance Abuse/Addiction (lcdcexamreview.wordpress.com)
Treating Substance Abuse/Addiction (Part II)
Contributor: Yvette McBride Thomas
Treating Illegal Drug Addiction
- Around half a million Americans are heroin addicts, and four million are regular users of marijuana.
- Treatment is often based on the AA model.
- Because of incarceration of illegal drug abusers, jail is the usual context for treatment.
- “Stay’n Out” is a prototype of a jail treatment program that works well and has a recidivism rate of only 25%.
Treating Families where there is Substance Abuse/Addiction
- Families either promote or enable substance abuse behaviors. The whole family has to be included in the treatment.
- Children with chemically dependent parents are at risk.
- Alcoholic families tend to be isolated and lack positive role models.
- Young people from dysfunctional families use substance abuse to
- Relieve stress and anxiety and structure time.
- Keep their minds off family dynamics and on predictable problematic behaviors.
- Substitute for sex and promote pseudo-individuation (a false sense of self).
Treatment Services
- Counselor can provide information.
- Counselor may have to be confrontational with the family over the effects of substance abuse on the family and individual. An intensive systems approach must be used that also involves agencies.
- Counselor can work to help family deal with feelings, such as anger and defense mechanisms.
- Counselors can also help the family take responsibility for their behaviors.
- Developmental issues are also worked on by the family.
Treating Women and Minority Cultural Groups in Substance Abuse
- Approximately five to seven million women abuse alcohol in the US alone.
- Women face societal rebuke and chastisement for alcohol abuse.
- Barriers to treatment include need for childcare, cost, family opposition, and inadequate diagnosis.
- Little evidence exists on the benefits of AA and NA on the one-third of the AA membership that women represent due to gender differences and cultural differences.
- “Women for Sobriety” is an alternative help group program that is based on a cognitive-behavior modification approach. Thinking is changed to overcome feelings of helplessness, powerlessness, guilt, and dependence.
- Cultural differences may play a part in the recovery process. Spiritual elements may be different for women and different ethnic backgrounds.
Affiliation, Certification, and Education of Substance Abuse Counselors
IC&RC
- The International Certification & Reciprocity Consortium.
- IC&RC’s credentials include
- Alcohol and Drug Counselor (ADC)
- Advanced Alcohol and Drug Counselor (AADC)
- Clinical Supervisor (CS)
- Prevention Specialist (PS)
- Certified Criminal Justice Addictions Professional (CCJP)
- Certified Co-Occurring Disorders Professional (CCDP)
- Certified Co-Occurring Disorders Professional Diplomate (CCDPD)
- The IC&RC is currently developing a Peer Mentor (PM) credential.
TCBAP
- Texas Certification Board of Addictions Professionals
• IAAOC
- International Association of Addictions and Offender Counseling
- Focuses on the prevention, treatment, and description of abusive and addictive behaviors.
- Publishes the Journal of Addictions & Offender Counseling
• NAADAC
- National Association of Alcoholism and Drug Abuse Counselors
- A national organization that certifies addiction counselors
• NBCC
- In 1994 the National Board of Certified Counselors added a certification process for becoming a substance abuse counselor.
Two types of counselors
- Recovering counselors
- Nonrecovering counselors
Reference:
Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
Preventing Substance Abuse/Addiction
Contributor: Yvette McBride Thomas
Prevention Programs
“Just Say No”
- Sponsored by local governments and found in schools and public agencies.
- The program’s message is incorporated into public service announcements on television to influence preteens and teens by their peers to say “no” when offered a cigarette or other addictive or dangerous substance.
D.A.R.E.
- Drug Abuse Resistance Education
- Found in late elementary and early middle school grades
- Uses police as instructors and provides case scenarios that challenge fifth and sixth graders to think about and answer them.
S.A.D.D. and M.A.D.D.
- Students against Drunk Driving
- Mothers against Drunk Driving
- These associations help educate and orient young people about the hazards of drug abuse and the dangers of addiction
Tobacco and Cocaine Programs
- These programs focus on the external and internal factors important to teens. External factors
- External factors include: breath, teeth, clothes, and costs.
- Internal factors include: lifestyle choices, time management, and nutrition.
- Group pressure and dynamics are common elements in prevention.
- Adolescents who get involved in the use of drugs do so because of friends who use drugs.
- When a group perceives drugs as hazardous, its members are less likely to engage in the behavior.
- Educational and support groups are a valuable tool to help ward off abuse and addictive behaviors
Reference:
Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
6. Client, Family, and Community Education
Addiction counselors play an important role in providing clients, families, significant others, and community groups with information about the risks involved with alcohol, tobacco, and other drugs use, as well as available prevention, treatment and recovery resources.
Our competencies in this area are:
- To provide education both formal and informal about substance abuse prevention and treatment programs, and the recovery process. In order to help people from multicultural backgrounds, we need to keep in mind:
- Cultural differences among diverse communities.
- Cultural differences in substance use behaviors.
- Delivery of educational programs that are culturally relevant.
- Research and theory on prevention of substance abuse problems.
- Learning styles and teaching methods that we can adapt to our clients.
- How to facilitate discussions in a safe and respectful environment.
- How to preparing outlines and handout materials.
- How to make public presentations to deliver the information effectively.
- Cultural issues in planning prevention and treatment programs.
- Age and gender differences in substance use patterns.
- Culture, gender, and age-appropriate prevention, treatment, and recovery resources.
- Awareness of our own cultural biases.
- To describe the risk and protective factors that increase and decrease the likelihood for an individual, community, or group to develop a substance use disorder. Our knowledge in this area includes:
- Risk and protective factors for the onset of substance use disorders.
- How to present the issues from a non-judgmental perspective.
- To describe the warning signs, symptoms, and the course of substance use disorders. We must be familiar with:
- The continuum of use and abuse, including the warning signs and symptoms of a developing substance use disorder.
- The current Diagnostic and Statistical Manual of Mental Disorders (DSM) categories or other diagnostic standards associated with psychoactive substance use.
- To describe how substance use disorders affect families and significant others. We need to educate our client about:
- How psychoactive substance use by one family member affects other family members or significant others.
- The family’s influence on the development and continuation of a substance use disorder.
- The role of the family, couple, or significant others in treatment and recovery.
- To describe the continuum of care and resources available to the family and significant others. Our goals are:
- To present available treatment options, including local health, allied health, and behavioral health resources.
- To motivate both family members and the client to seek out resources and services from the full continuum of care.
- To describe different treatment modalities.
- To identify and make referrals to local health, allied health, and behavioral health resources.
- Although this may sounds easy to do, we need to keep in mind the difficulties families and significant others go through when seeking help. We must work from a strengths-based principle, which emphasizes client autonomy.
- We must be familiar with the models for substance abuse prevention and treatment, and recovery from substance use disorders.
- Awareness of our own biases when presenting the information.
- Delivering educational sessions.
Client Education
Client education includes the provision of information concerning alcohol and other drug abuse, its consequences, and available services and resources created to help people overcome their addictions.
Global Criteria
- Present relevant information about alcohol and other drug use and abuse to the client, through formal and informal processes.
- Present information about available support services and resources for the treatment of alcohol and other drug abuse.
Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.