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Substance Abuse. This PPT contains material that has not been covered in lecture, however, you are responsible to have knowledge of the content. If you have any questions, please feel free to contact me. Ms Gilber t. Growth & Development Chemical Dependency. Substance Abuse
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Substance Abuse This PPT contains material that has not been covered in lecture, however, you are responsible to have knowledge of the content. If you have any questions, please feel free to contact me. Ms Gilbert
Growth & Development Chemical Dependency Substance Abuse • A maladaptive pattern of substance use leading to clinically significant impairment or distress • Must meet at least one category in year: • Fail to meet obligations due to use • Recurrent use despite physical hazards • Recurrent legal problems from use • Continued or persistent social or interpersonal problems caused by use
Growth & Development Chemical Dependency Defense Mechanisms that Contribute to Substance Abuse Maintenance • Rationalization: Falsifying an experience by giving a contrived, socially acceptable and logical explanation to justify using (I was entertaining some business friends, and we ran late). • Blame-shifting: If my boyfriend wasn’t so uncaring, I wouldn’t need coke to get through the day • Denial: Escaping unpleasant realities by ignoring their existence (I’m sick of everyone thinking I drink too much. I can control my drinking whenever I want and stop whenever I want).
Growth & Development Chemical Dependency Threats to Substance Abusers by the Nurse 1. Fear of being rejected (not all nurses are equally willing to care for addicted people) 2. Fear of recovery (they must give up the substance they feel they need to survive) 3. Fear of failing to recover (many have past failed attempts and trying to recover always poses the risk of failure)
Growth & Development Chemical Dependency Opioid Abuse • Class I: Opium, Heroin • Class II: Morphine, Demerol, Methadone, Dilaudid, Percocet • Class III: Vicodin, Tylenol # 3, opium morphine heroin • Demerol and Methadone are synthetics • Therapeutic doses mild depression of nerves, skeletal muscles, & heart muscle, constipation • High Doses confusion, impaired speech; staggering; difficulty thinking, concentrating & working; poor emotional control; deep sleep leading to loss of consciousness; memory loss; respiratory depression; death
Growth & Development Chemical Dependency Interventions Based on Stage Client is In • Precontemplation: • Assist the client in becoming aware of the problem “Your liver enzymes are elevated.” • Contemplation: • Assist the client in becoming ambivalent about the problem, tipping the scales toward change: “What are some of the advantages to continuing to drink? What are some of the disadvantages? Promise me that you’ll think about this.”
Growth & Development Chemical Dependency Effecting Change: • Express Empathy • Skillful, reflective listening, acceptance • Develop Discrepancy • Awareness of consequences • Discrepancy between present behavior and important goals • The client presents arguments for change
Growth & Development Chemical Dependency Making change: • Avoid Argumentation • Arguments are counterproductive and breed defensiveness • Roll With Resistance • Ambivalence and reluctance are acknowledged as being understandable • Support Self-Efficacy • Client must believe change is possible • Client is responsible (response-able)
Growth & Development Chemical Dependency Interventions Based on Stage Client is In (c0nt) • Preparation: • Assist the client in planning for his recovery: “What steps can you take now to help you have the best chance of success?” • Action: • “I want you to go to 90 AA meetings in the next 90 days and get a sponsor.” • Maintenance: • Assist the client to identify triggers and relapse behaviors