CHAPTER 1 Introduction to Substance Abuse Counseling Theory

CHAPTER 1: Introduction to Substance Abuse Counseling: Theory and Practice Fifth Edition Patricia Stevens Robert L. Smith Prepared by: Dr. Susan Rose, University of the Cumberlands

Chapter Overview ● ● ● ● Introduction The History of Substance: No Wonder We Use Societal Costs of ATOD Use, Abuse, and Dependency Subtance-Related Diseases The Importance of Terminology in Substance Abuse Counseling The Profession in the 21 st Century An Overview of This Book Conclusion Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -2

Introduction ● In 2009, an estimated 69. 7 million Americans aged 12 or older were current (past month) user of a tobacco product. § This represents 27. 7% of the population in that age range Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -3

Introduction ● In the same 2009 survey, 51. 9% of American aged 12 or older reported being current drinkers of alcohol § The rate of current alcohol use among youths aged 12 to 17 was 14. 7%. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -4

Introduction ● Relationship between drugs and criminal behavior: § In 2004, 17% of U. S. state prisoners and 18% of federal inmates said they committed their current offense to obtain money for drugs. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -5

Introduction ● Relationship between alcohol and criminal behavior: § About 73% of felonies are alcohol related. § In about 67% of child-beating cases, 41% of forcible rape cases, 80% of wife-battering, 72% of stabbings, and 83% of homicides, either the attacker or the victim or both had been drinking. § In 2009, an average of one alcohol-impaireddriving fatality occurred every 48 minutes Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -6

Introduction ● In 2009, an estimated 21. 8 Americans aged 12 or older were current (past month) drug users § Among youths aged 12 to 17, the current illicit drug use rate increased from 9. 3% in 2008 to 10. 0% in 2009. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -7

The History of Substance Abuse ●Over the centuries, drugs have been used: Medicinally Religiously Socially Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -8

The History of Substance Abuse Alcohol Cocaine Heroin Marijuana Opioids Amphetamines Hallucinogens Tobacco Caffeine Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -9

Societal Costs of ATOD Use, Abuse, and Dependency ● The largest proportion of costs is from lost potential productivity, followed by: § Nonhealth “other” costs and § Health-related costs ● Drug abuse and dependency reduce the capacity of individuals to work productively in their workplace and homes. § One source of loss is the shortfall in wages and employment among drug abusers – Accounts for $14. 2 billion. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -10

Societal Costs of ATOD Use, Abuse, and Dependency Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -11

Societal Costs of ATOD Use, Abuse, and Dependency Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -12

Societal Costs of ATOD Use, Abuse, and Dependency ● Other costs associated with chemical use: § Losses to society from premature deaths and fetal alcohol syndrome § Costs involving the criminal justice system and social welfare administration § Property losses form alcohol-related motor vehicle crashes § Costs related to Hepatitis C and HIV/AIDS Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -13

Substance-Related Diseases Hepatitis • Hepatitis B is most common cause of liver disease in the world • Hepatitis C is the most common blood-born infection in the U. S. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved HIV/AIDS • In the U. S. , the most common means by which HIV-1 is transmitted is by sharing contaminated needles. • Further infection comes from sexual relations with an infected partner. (More than 90% of HIV infections worldwide have resulted from heterosexual intercourse. 1 -14

The Importance of Terminology in Substance Abuse Counseling Substance abuse/Substance dependency: client’s use pattern ● Two components separate the diagnostic categories of “abuse” or “dependence”: tolerance and withdrawal § Tolerance means that a higher dosage of the drug is needed to produce the same level of effect over a period of time. ● Substance/Chemical: alcohol, nicotine, caffeine, prescription drugs, and illegal drugs. ● Drug: any nonfood substance whose chemical or physical nature significantly alters structure, function, or perception (vision, taste, hearing, touch, and smell) in the living organism. ● Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -15

The Importance of Terminology in Substance Abuse Counseling ● Drug user/Substance Abuser: a person who intentionally takes legal or illegal drugs to alter his or her functioning or state of consciousness. ● Substance Abuse: the use of a drug without medical justification that would injure or do damage. § More specifically defined as the continued use of a psychoactive drug despite the occurrence of major detrimental effects associated with its use, such as social, vocational, health, scholastic, or economic difficulties. ● Misuse: using a substance in a manner that causes detrimental effects in some areas of the person’s life. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -16

The Profession in the 21 st Century ● Collaborative approach § Motivational Interviewing (MI) § Process to elicit change in the client through skillful questioning § MI recognizes that change comes from within the client and that the client-counselor interaction is the most powerful aspect of the treatment process ● Research-based programs § Evidence-based practices Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -17

The Importance of Terminology in Substance Abuse Counseling ● Tolerance and Withdrawal further discussed. § Differentiates between abuse and dependency. § Two types of Tolerance § Metabolic tolerance refers to liver function. § Pharmacodynamic tolerance is the central nervous system’s increasing sensitivity to a chemical. ● Withdrawal refers to a specific set of symptoms that occur when use of the drug is discontinued. § Withdrawal syndrome is strong evidence of dependence addiction. ● Drug use, misuse, abuse and addiction is a continuum of behavior. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -18

Overview of Book ● My. Counseling. Lab § Learning outcomes for text along with national standards that connect to these outcomes § Assignments and Activities § Building Counseling Skills Unit § Practice for Certification Quiz § Video and Resource Library Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -19

Discussion ● Discuss the relationship between social structures, culture, and the use of substances (Drugs and Alcohol) throughout history. § ● That is, what in our history has influenced substance abuse? What do you see as the main differences between substance use, misuse, abuse and dependence? § How do practitioners see the differences? § Is it different from the general public? Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -20

Discussion ● From your own experiences, from observing others, and from your reading, what do you think are the factors influencing the use of different drugs—tobacco, alcohol, marijuana, cocaine, etc. ? ● Critique or defend the concept of “we live and always will live in a society of drug use and abuse. ” § Discuss factors related to this statement and costs involved. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5 e © 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights Reserved 1 -21