Bshs 431 Substance Abuse Prevention Research Paper

Prevention, Intervention, Treatment, and Relapse Strategies

BSHS 431
August 13, 2012

Prevention, Intervention, Treatment, and Relapse Prevention Strategies
Drug and Alcohol are powerful chronic addictions that have no mercy on individuals who have arrived at this stage of the disease. Prevention strategies in schools, home, and community are essential for adolescence to find other means for coping and expression. Healthy family foundations, communication, education, and activities are essential for youth to avoid the temptation of substance use. Intervention is an event or act by an individual interrupting the progression of problems with substance use. (Fields, 2010) There are a variety of treatment and therapy models
used to ensure success for most substance abusers and addicts. In addition, relapse prevention strategies are imperative in providing specific tools and techniques to keep the addict from returning to active addiction.
Taking a pro-active instead of reactive approach in educating, empowering adolescent in the destructive patterns of substance addiction is a vital part of the prevention strategy. A balanced family structure where there is open communication, nurturing, bonding, and guidance is a solid foundation for children to thrive. “Family bonding is the bedrock of the relationship between parents and children. Bonding can be strengthened through skills training on parent supportiveness of children, parent-child communication, and parental involvement”. (NIDA, 2011) Unfortunately, parents will say “Don’t Do Drugs” while they sip on alcoholic beverages, smoke cigarettes, or use drugs. Many parents assume public education will teach their children about the dangers of drug and alcohol abuse. Early prevention approaches by society used scare tactics in trying to dissuade young people from using drugs and alcohol. “These tactics proved to be an ineffective prevention strategy”. (Fields, 2010) When using scare tactics most of the information is exaggerated and invalid causing young people to question the credibility of the messenger.
Using preventive strategies with young people, such as alternative activities approaches focuses on the natural innate drive to alter the sense of consciousness (Fields, 2011). The goal is teaching individuals they are capable of altering their consciousness in a longer-lasting, meaningful, and fulfilling way incompatible with substance use. In short, individuals are encouraged to find interests and activities where they can grow, develop, and master. An alternative activity builds character by teaching commitment, will power, perseverance, and a sense of accomplishment.
Prevention and special populations focus on people of color and other minorities at risk for substance use and addiction problems. Minorities are considered to be at a higher risk because of lower socioeconomic conditions, unemployment, and living in poverty. The stress of inadequate education, housing, and low or no income causes frustration and anger. The feelings of hopelessness can cause an individual to want to desensitize from reality and turn to drugs and alcohol to escape. “Prevention for people of color and other minorities must be community based. Residents must conceptualize the problem and jointly develop appropriate strategies.” (Fields, 2010) Most residents in these communities need assistance and drug awareness prevention education in preparation to helping others. There are a few nonprofit organizations that assist but not enough to make an impact in the community. Parents in the community should be taught parenting classes with an emphasis on bonding, positive communication, and social interaction with their children to start the process of healing in the community.
Intervention is the process in which family members or professionals intervene when it is obvious an individual has a problem with substance abuse.
Typically, the individual will deny having a problem with drugs or alcohol and it is the process of intervention that reveals the contrary. Encouraging the addict to get treatment as early as possible is essential, however; this can be challenging. Most addicts are deep in their addiction and may not think they have a problem. Today, individuals who use prescription opioids may say “my doctor prescribed this for me” and not be honest that they may be going to one or more doctor for medication. Many addicts have been using for a long time and afraid of how they will be without the drug. As long as an addict is actively using and has the means to get the drug, it would be difficult for them to agree to an intervention and stop using. Typically an addict will be willing to try recovery when they have no more drugs and are going through withdrawal. Otherwise, one will be met with denial, and resistance to change. The role of the family is vital during an intervention. It is imperative that family member stop enabling the addict by giving money, posting bail, and covering when he or she fails to go to work or school. This will bring the addict closer to the reality of their addiction and their world will begin to crumble.
“William Miller and Stephen Rollnick (1991) developed a form of intervention known as motivational interviewing.”
(Fields, 2011) Motivational interviewing uses strategies from a variety of disciplines, including:
Cognitive Therapy – Makes the assumption that thoughts precede moods and that false self-beliefs lead to negative emotions. Cognitive therapy aims to help the patient recognize and reassess his patterns of negative thoughts and replace them with positive thoughts that more closely reflect reality.
Client-centered counseling- Listen and try to understand how things are from their point of view.
The client must be motivated, eager to change and at a state of readiness in order for the therapist to make an impact. The process of the therapist’s motivational tasks includes raising doubt about the client’s perception of risks and behaviors related drug use. Evoke reasons why a change is necessary and the risks if no change is made. In addition, the therapist will let the client determine the course of action they will take in seeking change; this will give the client a sense of empowerment. The last step and one of the most important is helping the client identify triggers and how to use strategic tools to prevent relapse.
Treatment is the next step once a client agrees to receive help. There are a variety of treatment methods available for drug and alcohol use. Extended length stay facilities for residential inpatient programs are from 30 to 180 days. “The traditional 30-day residential or inpatient alcohol/drug treatment program is the current mainstay of treatment in the first decade of the twenty-first century.” (Fields, 2011) The treatment program includes cognitive-behavioral therapy, treatment for co-occurring disorders, post traumatic stress disorder, and medications to reduce craving and affective disorders.
Outpatient programs treatment clinics include medically supervised programs that provide crisis-oriented medical services to clients. Typically outpatient programs are drop in/crisis counseling centers and focus on crisis intervention, medical care and health services, welfare and social services.
Methadone treatment center focus on client’s detoxification from opioids and continued maintenance. The maintenance program consists of client’s participation in group and individual education, counseling, and 12-step programs. Methadone is used to help the client withdrawal from addiction to heroin; however, the client will become dependent on methadone.
Self –help meeting such as the 12-step programs found that willpower alone is not enough to keep people from using drugs and alcohol. There are 12-step meeting today over the world for individuals to attend for support. There are no fees or requirements for membership; only the desire to stop using. The 12-step program places importance for individuals to develop a relationship with a “higher power” to their understanding.
Rational Recovery (RR) is an alternative to all self-help groups such as Alcohol or Narcotics Anonymous.
“The principals of RR are based on the rational-emotive approach developed by Albert Ellis, PH.D.” (Fields, 2010) Rational Recovery focus on changing the way client’s think and feel about themselves and use of substances. “Rational Recovery groups developed an organization, called SMART Recovery is based on rational-emotive behavioral therapy and cognitive-behavioral approaches.’ (Fields, 2010) The rational –emotive behavioral therapy is an alternative to the 12-step programs and focuses on the individual responsibility for their maladaptive behaviors and is capable of gaining control over such behaviors. In addition labeling oneself an alcoholic or addict is discouraged and not necessary to
recover.
Relapse prevention is by far just as important as the various treatments associated with substance abuse. Addicts in a negative state such as hunger, tired, and angry are susceptible to relapsing in an effort to find that old place of false comfort. In addition, cravings, urges, familiarity of places where the substance was ingested can set off triggers to use again. Every individual is unique in their recovery and many factors should be addressed to know how to help. “Has the patient relapsed previously, and can the factors that precipitated use be identified? What are the current stressors that might precipitate relapse, and what are the protective factors against relapse.” (Compton, 2011) In addition, possible untreated psychiatric disorders should be indentified and treated to avoid negative emotional states that can result in relapse. Relapse prevention strategies education is essential in helping clients recognize the signs and issues that may cause relapse. “Reservations can be anything: a belief that because we never had a problem with one particular drug we can still use it; placing conditions on our recovery, such as only staying clean as long as our expectations are met; a belief that we can use again after a certain amount of clean time”. (NA, n.d) If reservations are kept, individuals are reserving a place in their recovery for relapse.
Living a balanced, healthy lifestyle after drug addiction and alcohol abuse is vital in keeping the individual from relapsing into to active addiction. Support from family members, friends is an instrumental part of the individuals recovery process. An individual in recovery should be informed of all the available tools, such as self and individual groups and programs to help him or her succeed. Ironically, the same principals of alternative activities come into play at this stage where an addict must find healthy activities stimulating and rewarding. This process will introduce an individual to a new way of living, clean, and sober.

References
Compton, P. (2011). Treating Chronic Pain with Prescription Opioids in the Substance Abuser:Relapse Prevention and Management. Journal of Addictions Nursing, 1(22), 39-45.
Fields, R. (2010). Drugs in Perspective: A Personalized look (7th ed.). New York, NY: McGraw Hill.
National Institute on Drug Abuse NIDA (2011) Drug Facts: Lessons from Prevention Research
NA (n.d.) The Twelve Steps and Twelve Traditions of Narcotics Anonymous “It Works How and Why”