Substance Abuse Treatment & Stages of Change

People with addictive disorders are more likely to appear in general health care and menetal health care instead of specialized programs

Addiction is preventative, more likely to result in remission

Comorbid diagnosis is high

Pioneered by EM Jellinek's "disease model" which recognized the physiological effect of addiction. Addiction is not just mental!

American Medical Association recognized alcohol and drug addiction as a disease in the 1950s

Addiction - Generic term, but substance use disorder is preferred

Drug - psychoactive substances

Drug addiction - dependence marked by increasing tolerance and withdrawal, craving or preoccupation, and loss of control over the drug and ordinary social behavior

Overcome stigma and prejudice

Working through stigma and negative attitudes

Multidisciplinary collaboration

Cultural sensitivity

You have a character flaw!!

Discrimination - society will blame you for your problems!

Hopeless about future - I can't do anything about it

Shame - labeled offensive terms

1. You need specialized treatment to recover!

2. It takes lots of time

3. TO be effective as a counselor, you have to be in recovery yourself
- empathy is the most important

4. Treatment doesn't work
-It takes time and patience

Alcohol
-50% of people aged twelve or older used alcohol in the past month
-61 million binge drinkers and 17 million heavy users

Illicit drug use
-21% of people 12+ in the past year
-Highest rates of marijuana use was in the adults aged 18-25

Deaths annually
-88,000 people per year from alcohol
-40% of all hospital emergency departments are used to treat conditions related to alcohol

Precontemplation

Contemplation

Preparation

Action

Maintenance

Termination

Stages describe attitudes, intentions, and behaviors that people possess at that stage

Each stage has a goal that must be met before progressing, but the stages are fluid

Reveling - enjoy the use
Reluctance - Lack of awareness or doesn't want to change
Rebellion - Heavy investment in problem behavior/I make my own decisions!!
Resignation - Lack of energy or investment in change
Rationalization - Have all the answers as to why the problem isn't a problem for them

Weighs pros and cons of change

Open to feedback

Willing to go through assessment

Distressed, thinking about change

First goal - sustain changes made during action stage
Second goal - avoid relapseecurrence

Generally starts after 6 months following successful action from last drink or drug use