Continuum of Substance Use

Continuum of Substance Use
Earn CEUs at AllCEUs.com NBCC #6261, NAADAC

#599
Copyright AllCEUs 2006-2020
Objectives
 To provide information about substance abuse

 Toassist students in understanding the
symptoms and consequences of substance
use and abuse
 Tomotivate students to make informed choices
about substance use and abuse
Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Overview
 Substance use can be thought of on a continuum from
social/recreational use to abuse and dependence.
 Many factors affect whether substance use is a
problem including whether it causes significant
impairments in health, social, legal or occupational
functioning
 No certain amount of substance use necessarily
means there is a problem. It is important to consider
the situation, the consequences and whether the
person was in jeopardy of causing themselves physical
harm by using.
What is Addiction
 Three facets to the definition

– A person, substance, or activity
– Regularly used to escape from negative feeling
states
– Continues to be used despite experiencing
negative consequences.
– Note: Physiological dependence is NOT
necessarily a part of addiction
Definition of addiction cont…
 Anotherway to understand addiction is to

apply the four Cs:
– Behavior that is motivated by emotions ranging
along the Craving to Compulsion spectrum
– Continued use in spite of adverse Consequences,
and
– Loss of Control.

“Trademark” Addictive Behaviors
 Denial
 Manipulation
 Throwing focus
 Blaming
 Minimizing
 Rationalizing
The Continuum
Powerpoint Understanding Drug Abuse

 Recreational Use
 Gateway Drugs
 Abuse
 Dependence
 The “Slide”
Understanding the “Slide”
 Started with occasional  Memory blackouts increase
drinking for
relief/escape/relaxation
 Unable to discuss problems
 Things keep getting worse, so
 Harder to stop drinking
relief drinking becomes more  Starting to fail to keep
constant promises
 Needing more of the  Dramatic and/or aggressive
substance to get the same behavior began as people
high started to question your
 Started having blackouts behaviors
 The urge to use became
 Efforts to control the use of
more urgent the substance fail repeatedly
 Loss of other interests
 Began feeling guilty
Slide cont…
 You begin to avoid family and  You start having a decrease
friends in your ability to tolerate the
substance
 You begin to have
resentments (which you can  Your intoxication/use periods
later look back on as become longer (days or
unreasonable) weeks instead of a few hours)
 You start having problems at  Your body begins to
work and with money deteriorate under the stress of
the substance
 You have lost your will power
 Your thinking becomes
 You begin to neglect your impaired---judgment is bad,
diet, sleep and general health memory is lost

Understanding Addictive Behaviors
Definition of addiction: Diagnosis of a Problem
 Spent more time that anticipated trying to get the
substance, trying to be around the person or doing the
behavior (like gambling or sex)
 Used the substance, stayed in the relationship or did the
behavior (like gambling or sex) despite knowing the
problems it could cause
 Spent more money than you anticipated trying to get the
substance, do the behavior or stay in the relationship
 Failed to fulfill family/work/school obligations as a result
of using or recovering from use
Definition of addiction cont…
 Used more of the substance than intended
 Legal problems as a result of use, doing the behavior or
staying in the relationship
 Used the substance, did the behavior or stayed in the
relationship for longer than intended
 Work/home or family problems as a result of the use of the
substance, staying in the relationship or doing the behavior
 Needed more of the substance or activity for the same high
 Put yourself in dangerous situations while getting or using
the substance, doing the behavior or staying in the
relationship
Addiction Warning Signs
Read each statement carefully. Identify
which ones are warning signs and why.
 I experiment with alcohol or  I use drugs/drink regularly at
drugs social or sporting events
 I drink or use drugs  Using makes me feel like
occasionally in social settings one of the group
 I function well at work and  My rebellion is normal midlife
home or college behavior
 I use alcohol or drugs for  My tolerance to alcohol or
pleasure specific drugs has increased

Warning signs cont…
 My functioning at work  I hide my drinking or drug
remains stable use from my family
 I feel like I need to drink or  Most of my friends do drugs
use drugs or drink
 When you use you feel in  I devote less time and
control attention to school work
 I use drugs or drink on a  I drink or use drugs to feel
daily basis better
 Relationships with my family  I have lost control over my
are becoming strained use
Prevalence of the problem
 More than 50% of the population has a substance

abuse problem at some point in their lives.
 If you factor in non-drug addictions such as gambling,
sex and food, the number grows to closer to 75%
 Drug Abuse Statistics

Consequences of Addiction
 Individual
– Psychological, Cognitive, Social/Family,

Occupational, Financial, Environmental, Physical
 Community
– Crime, Commerce, Poverty, Social Modeling

Readiness for Change
 Precontemplation
– “I do not have a problem and nobody can convince me I do!”
 Contemplation
– I may use a bit too much sometimes, but I can get it under
control”
 Preparation
– “Okay, I have a bit of a problem and might consider listening to
what you have to say.”

Cont. . .
 Action
– “I have a problem and I cannot fix it by myself. Help me.”
 Maintenance
– “ I have a disease. It is in remission. I know what I need to do
to keep it that way and I am willing to do it.”
 Relapse
– “I recognize some of the signs of my disease coming back in
how I think, act and what I want to do. I know I need to take
action.”
Clean vs. Sober
 Clean=I have no drugs in my body or am not

engaging in the behavior to which I am
addicted.
 Sober= I am clean and am behaving honestly,
consciously and with courage and integrity.

Other addictive behaviors of
concern
 Eating Disorders
 Gambling
 Sexual Addiction
 Shopping Addiction
 Relationships
Generally any person, substance or activity which continues to

be used as a primary means of escape despite experiencing
negative consequences (legal, relationship, occupational,
health, emotional etc.)
Comprehensive Treatment
 Individual
 Family
 School/Work
 Community
 Society at large

Types of Recovery Programs
Treatment Methods Overview

 Self Help
 12-Step (pg. 247)
 Recovery SMART Recovery (pg. 249)
 Faith Based
 Client Centered
 Therapeutic Communities (Daytop, Samaritan Village, Phoenix
House)
Duration and Frequency of
Recovery Programs
 Self-Help
– Meets daily or weekly
– Usual involvement: several years
 Outpatient
– Meets weekly
– Usual involvement 12 weeks

Recovery Programs cont…
 Intensive Outpatient
– Meets 3-5 days per week 4 hours per day
– Usual involvement 12-24 weeks
 Residential
– 24/7 care
– Usual involvement 28 days for addictions programs and 6-12
months for dual diagnosis (addictions and mental health)

Levels of Prevention
 Primary
– Goals are to prevent the problem from occurring in the first
place
 Secondary
– Goals are to prevent the problem from getting worse
 Tertiary
– Goal are to prevent the problem from getting worse and
prevent any other complications
Information on Prevention Programs for Those Interested
Risk and Resiliency Factors
INDIVIDUAL
RISK FACTORS PROTECTIVE FACTORS
Certain physical, emotional or personality traits Knowledge regarding risks associated with
Inherited genetic vulnerability substance abuse/use
Low self esteem Negative attitudes toward substances and
substance use
Psychological disturbances
Bonding to pro-social culture
Inappropriate coping responses
Positive relationships with adults
Violence/ aggression
Views parents, teachers, doctors, law
Risk taking propensity/impulsivity
enforcement officers and other adults as allies
Alienation and rebelliousness
Social competence
Rejection of pro-social values/religion
Youth involvement in alternative activities
Lack of peer refusal skills
Sense of well-being/self confidence
Early and persistent problem behaviors
Has positive future plans
Early sexual activity/teen pregnancy
Early anti-social behavior
Peer rejection in elementary grades
Academic Failure
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Lack of information on positive health behaviors
Peer Risk Factors cont. . .

• Reinforcement of negative norms and • Involved in substance-free activities
expectations within peer group • Friends disapprove of alcohol and other
• Thinks alcohol and drug use is "cool" drug use
• Inappropriate sexual activity among peers
• Ties to deviant peers/gang involvement

Family Risk Factors

•Family members with a history of alcohol or •Close family relationships
other drug abuse •Consistency of parenting
•Familymembers don't spend much time •Education is valued and encouraged, and
together parents are actively involved
•Parentshave trouble keeping track of •Copes with stress in a positive way
teens, who they're with and where they go •Clearexpectations and limits regarding alcohol
•Lack of clear rules and consequences and other drug use
regarding alcohol and other drug use •Encourages supportive relationships with
•Parents use drugs, involve youth in their caring adults beyond the immediate family
use ("Get me a beer, would you?") or •Sharefamily responsibilities, including chores
tolerate use by youth
and decision making
•Parents have trouble setting consistent •Familymembers are nurturing and support
expectations and limits
each other
•Family conflict/abuse
•Loss of employment
School Risk Factors

Lack of clear expectations, both Positive attitudes toward school
academic and behavioral School bonding
Students lack commitment or sense of Regular school attendance
belonging at school
Communicates high academic and behavioral
High numbers of students who fail expectations
academically at school
Encourages goal-setting, academic
Parents and community members not achievement and positive social development
actively involved
Tutoring available
Positive instructional climate
Provides leadership and decision making
opportunities for students
Fosters active involvement of students, parents
and community members
Sponsors substance-free events
Earn CEUs at AllCEUs.comSchool
NBCCresponsive to students'
#6261, NAADAC #599 needs
Community Risk Factors

•Alcohol/other drugs readily available •Opportunities for community involvement
•Irresponsible servers and sellers •Community religious composition
•Laws and ordinances are unclear or •Laws are consistently enforced
inconsistently enforced •Informal social control
•Norms are unclear or encourage use •Policies and norms encourage non-use
•No sense of "connection" to community •Community service opportunities Resources
•Neighborhood disorganization (housing, healthcare, childcare, jobs, recreation,
•Rapid
changes in neighborhood High etc.) available
unemployment •Comprehensive risk focused programs available
•Residents at or below the poverty level for youth
•Lack •Programs for parents of children and
of strong social institutions
•Lack
adolescents
of monitoring youths' activities
•Early childhood and family support programs
•Inadequate media portrayals
•Misleading advertising
•Pro-use messages Copyright AllCEUs 2006-2020
Additional Resources
 The Higher Education Center for Alcohol and Other Drug Prevention http://www.edc.org/hec
 National Clearinghouse for Alcohol and Drug Information http://www.health.org
 National Council on Alcohol and Drug Dependence http://www.ncadd.org
 Center for Substance Abuse Prevention (CSAP) http://www.coresoft.comlcsap.html
 Virtual Clearinghouse on Alcohol, Tobacco, and Other Drugs http://www.ccsa.calatod.htm
 National Center on Addiction & Substance Abuse http://www.casacolumbia.org
 Promising Practices - Campus Alcohol Strategies http://www.promprac.gmu.edu
 Training for Intervention Procedures (TIPS) http://www.gettips.com
 Harvard School of Public Health College Alcohol Study http://hsph.harvard.edu/cas
 National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov
 National Institute on Drug Abuse http://www.nida.nih.gov
 AI-Anon http://www.al-anon.org
 Health finder http://www.healthfinder.gov
 Drugs Awareness Online: Use, Abuse, & Treatment http://www.mhhe.comlhper/health/drugs
Summary
 Substance abuse is defined by impairment in one or
more areas of functioning over a 12 month period as a
result of substance use
 More than 50% of people have an addiction
 There are a host of outpatient and more intensive
programs and styles


Continuum of Substance Use

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Continuum of Substance Use

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Continuum of Substance Use

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC

 To provide information about substance abuse

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

 Three facets to the definition

 Anotherway to understand addiction is to

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Powerpoint Understanding Drug Abuse

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

 More than 50% of the population has a substance

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

– Psychological, Cognitive, Social/Family,

– Crime, Commerce, Poverty, Social Modeling

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

 Clean=I have no drugs in my body or am not

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Generally any person, substance or activity which continues to

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Treatment Methods Overview

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

RISK FACTORS PROTECTIVE FACTORS

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

RISK FACTORS PROTECTIVE FACTORS

RISK FACTORS PROTECTIVE FACTORS

RISK FACTORS PROTECTIVE FACTORS

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

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