GROUP MEMBERS

TRECIA BENT OVELL BURTON JODY-ANN PRYCE

SOME DEFINITIONS
ETIOLOGY - The study of the cause of diseases.
SUBSTANCE DISORDER

1. Substance Abuse a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances (APA 2000, p. 198).

SOME DEFINITIONS cont.

2. Substance Dependence -This maladaptive pattern of substance use includes such features as increased tolerance for the substance, resulting in the need for ever-greater amounts of the substance to achieve the intended effect. (APA 2000)

WHAT ARE SUBSTANCE RELATED DISORDER?

Prescription medications that may be abused (such as

sedatives), Opioids (morphine, heroin) Marijuana (cannabis) Cocaine Hallucinogens Phencyclidine PCP
(Tasman, Allan, Jerald Kay MD, and Jeffrey A. Lieberman MD. 1997 )

WHAT IS SUBSTANCE RELATED DISORDER cont?

Substance-related disorders are disorders of

intoxication, dependence, abuse, and substance withdrawal caused by various substances, both legal and illegal. Alcohol Caffeine Inhalants Nicotine

THE THREE CATEGORIES OF DRUGS

Depressants alcohol, Heroin, morphine, codeine methadone, barbiturates, and tranquilizers. ( Inhalants such as glue, paint thinner, and hair spray are also considered depressants and have the same effect as alcohol. 2. Stimulants - coffee and caffeine. (cocaine and amphetamines. These are illegal stimulants) 3. Hallucinogen or mind-altering drugs - Marijuana and ecstasy.
1.

EFFECTS OF THE THREE CATEGORIES OF DRUGS

Depressants depresses the central nervous system and reduce pain relieving stress, anxiety, and fear putting the person at ease. However, depressants are very addictive and the end result is usually a lessening of ones ability to deal with any stress, fear, or anxiety. 2. Stimulants - Stimulates elevate the mood, producing feelings of excitement, feeling good, and euphoria. Stimulants give the user an adrenaline rush often followed by a crash.
1.

EFFECTS OF THE THREE CATEGORIES OF DRUGS cont.

3. Hallucinogen or mind-altering drugs - extremely dangerous and unpredictable. Users of hallucinogens, experience a complete fantasy or hallucination including; out of body experiences or misperceptions of reality, distortion, the mixes of senses - hearing colors and seeing sounds, and experience a combination of emotions or go from one emotion to the next rapidly

EFFECTS OF THE THREE CATEGORIES OF DRUGS cont.

. Users may experience what is known as a "good" trip

or a "bad" trip. A "Bad" trip, which is similar to a panic or anxiety attack, can result in violent behavior toward oneself or someone else or the person can suffer a mental breakdown. (Erika V. Cox, 2006).

WHAT IS SUBSTANCE ABUSE DISORDER?

Can be define as using a drug in a way that is

inconsistent with medical or social norm and despite negative consequences. (Sheila L. Videbeck, 2001)
People with substance abuse disorders may not be

dependent on their substances of choice, but they use them in a socially unacceptable or alarming way or with frequency that suggests abuse.

WHAT IS SUBSTANCE ABUSE DISORDER cont?

Repeated use of the substance in ways that would be

considered physically harmful Use of the substance is impacting the ability of the individual to meet their family, social, or work commitments Continued use of the substance despite evidence that it is leading to difficulties (DSM IV EMIL KRAEPELIN,2000)

ETIOLOGY OF SUBSTANCE ABUSE

It means "origin" when you use it to describe illness or

medical disorders It speaks to the exact causes of drug abuse Dependence Addiction Eg. Studies have looked at biological and generic factors has been done on alcohol abuse, but psychological, social and environmental studies have examined other drugs as well. (Sheila L. Videbeck, 2001)

ETIOLOGY OF SUBSTANCE ABUSE

Alcoholism and Genetics 51% of cases of alcoholism are non-familial, genetics has been well established in alcoholism, particularly among male alcoholics. Children with alcoholic parents shows a high risk of inheriting this trait from their parents. Cannabis and Cigarette Addiction is said to be one the most important cause as to why people abuse this drug. It is believe that smokers work consciously or unconsciously to maintain blood nicotine level.

SUBSTANCE ABUSE SYMPTOMS

1. Frequent intoxication the person report or appear to be frequently high or

intoxicated. recreational activities center around drinking or other drug use. 2. Social settings person socially isolated from others and is substance abusing . person is reluctant to attend social events where chemicals won't be available.

SUBSTANCE ABUSE SYMPTOMS cont.

3. Intentional heavy use the person use "social drugs" with prescribed medications
4. Symptomatic drinking the person made lifestyle changes yet the drug use has stayed the same or increased? (e.g. changed friends or moved to another area) 5. Belligerence the person defensive or angry when confronted about chemical use?

SUBSTANCE ABUSE SYMPTOMS cont.

6. Problems with law or authority the person seem angry at "the system" and at authority figures in general 7. Problems with significant others important relationships been lost or impaired due to chemical use.
(National Council on Alcoholism and Drug Dependence, Inc. 2012)

DIFFERENTIAL DIAGNOSIS OF SUBSTANCE ABUSE

Differential diagnosis of substance use disorders and

mental illnesses involves inherent difficulties because they co-occur to a very high degree. many clients have been misdiagnosed as mentally ill -- depressed, schizophrenic, bipolar, or personality disordered.

WAYS TO PROPERLY DIAGNOSE SUBSTANCE ABUSE

1. Time of onset. If the psychiatric difficulties began prior to the substance use, then it is likely that a psychiatric disorder exists. 2. Substance use patterns. A psychiatric disorder likely exists if the psychiatric symptoms persist during significant periods of abstinence from substance use (three months or longer).

WAYS TO PROPERLY DIAGNOSE SUBSTANCE ABUSE cont.

3. Consistency of symptoms. If the nature and magnitude of the client's symptoms and problems are qualitatively different or beyond what one would expect given the amount and type of substance used then a psychiatric disorder likely exists. 4. Family History. Many psychiatric conditions have a strong hereditary component, and a family history of mental illness can support the suspicion that a particular client has a mental illness.

WAYS TO PROPERLY DIAGNOSE SUBSTANCE ABUSE cont.

5. Response to substance abuse treatment. Clients with both psychiatric and substance use disorders often have significant difficulty complying with traditional substance abuse treatment programs and relapse during or shortly after treatment

WAYS TO PROPERLY DIAGNOSE SUBSTANCE ABUSE cont.

6. Client's stated reason for substance use. Individuals

with a primary psychiatric diagnosis and secondary substance use disorders will often say that they "medicate symptoms" -- they drink to quiet auditory hallucinations, they use stimulants to ease depression, they use alcohol or another depressant to take the edge off anxiety or soothe a manic phase. Substance use will likely exacerbate psychotic conditions, but this does not mean that the psychiatric condition is substance induced. Treating the disorder with medication and assessing the response can also provide valuable information. (DSM-IV Emil Kraepelin,2000)

 Historically, psychoactive substances have served a variety

EPIDEMIOLOGICAL ASSESSEMENTS OF SUBSTANCE ABUSE (American Context)

of purposes, including medicinal, social, recreational and religious. In the US, 90% of people report some alcohol use, 80% report some cafeine use, 25% report use of tobacco products, and 37% report having used illicit substances. Alcohol Over 10 mil Americans are alcoholics; over 8 mil are problem drinkers. Only 3% of alcoholics are on skid row. It is more common in males than females, and more common in adults than teens. Teenage alcoholism is 15% in America. 31% of high school students were intoxicated 6 or more times in the past

EPIDEMIOLOGICAL ASSESSEMENTS OF SUBSTANCE ABUSE American Context cont.

Other Substances The lifetime prevalence of abuse for substances other than alcohol is as follows: Amphetamines: 2% Cannabis: 4% Cocaine: 0.2% Hallucinogens: 0.3% Opioids: 0.7% Sedative hypnotics: 1.1%

EPIDEMIOLOGICAL ASSESSEMENTS OF SUBSTANCE ABUSE, Jamaican Context

Community Based Surveys: Rapid Assessment Surveys Parish profiles Special Projects data Tek it to Dem Project Monitoring &Evaluation for Drug Prevention Programmes Narcotics Division Drug Seizure Reports Treatment Centres EPI SIDUC

EPIDEMIOLOGICAL ASSESSEMENTS OF SUBSTANCE ABUSE, Jamaican Context

Patterns of Substance Use Among Youth (2006)

PROFILE OF DRUG USE IN JAMAICA

Most commonly used drugs: alcohol, marijuana,

tobacco and crack/cocaine. Alcohol is most common drug of use and abuse among adolescents and young adults

Cigarettes & other tobacco products has increased

Smoking before 10yrs increased from 18.7% in 2006 to

20% in 2010 Male use of cigarettes increased from 40.8% in 2006 to 47.4% in 2010 Needing to smoke first thing in the morning increased form 5.9% in 2006 to 13.4% in 2010

RISK FACTORS
Media Influences Peer Pressure Accessibility and Availability

(Uki Atkinson, Research Analyst, National Council on Drug Abuse,2012.)

EBSCO SOURCES #1
Mental Health Issues in Recently Returning Women Veterans: Implications for Practice. Sexual harassment and MST have been found to be associated with substance abuse, especially alcohol (Gradus et al., 2008; Skinner et al., 2000). Substance abuse, almost universally alcohol abuse, has been found to be a problem in veteran populations, including women returning from recent wars. Female veterans' service use, noted that substance use disorders are common following traumatic exposure but tend to be under diagnosed. (Authors : Carlson, Bonnie E. Stromwall, Layne K. Lietz, Cynthia A.)

EBSCO SOURCES #2
Routine Use of Screening and Brief Intervention for College Students in a University Counseling Center. Alcohol is the most widely used substance among college students (SAMHSA 2004). Alcohol-use patterns among college students range from occasional use in social settings to binge drinking problems. Binge drinking is dened as ve or more drinks on one occasion for men and four or more drinks for women (NIAAA 2004). Male students typically have higher rates of binge drinking than do female students (Fleming 2002). White students report signicantly higher rates of heavy drinking than do their Black, Hispanic, and Asian peers (Fleming 2002)

EBSCO SOURCES #2 cont.

One explanation for heavy drinking among college

students is that it often is seen as a type of rite of passage for students. As such, it is something students tend to regard as acceptable and normative behavior (Boekeloo, Novik & Bush 2011; Crawford & Novak 2006). Despite its apparent acceptance, heavy drinking can result in various adverse consequences, such as injurious accidents, sexual abuse, ghting, and even death (Hingson et al. 2002). (Authors:Denering, Loretta L. Spear, Suzanne E.)

EBSCO SOURCES #3 Fetal Alcohol Spectrum Disorders

EBSCO SOURCES #3 cont.

The terminology used to define and diagnose the adverse

effects of prenatal alcohol exposure has evolved since the first formal description of FAS (Jones and Smith 1973; Lemoineet al. 1968). The only diagnosis of an effect of prenatal alcohol exposure that currently is widely accepted remains the full presentation of FAS.

EBSCO SOURCES #3 cont.

(KennethR. Warren, Ph.D.;Brenda G. Hewitt; and

Jennifer D.Thomas, Ph.D)

INTERVENTION AND TREATMENT OF SUBSTANCE-USE DISORDER

INTERVENTION AND TREATMENT OF SUBSTANCE-USE DISORDER cont.

NB. Treatment for substance abuser and addict

depends on both the individual user and the type of drug being used. 1. Most drug and alcohol treatment programs involve two phases. Removal of abusive substance (detoxification) The user is prevented from consuming the substance. Removal of the substance my trigger withdrawal symptoms

INTERVENTION AND TREATMENT OF SUBSTANCE-USE DISORDER cont.

that are opposite in effects to the reaction produced by the drug. Eg. A person who is physically addicted to a central nervous system depressant such as a barbiturate will experience drowsiness, decreased respiration and reduced anxiety when taking the drug. However when withdrawn from the substance the user will experience agitation, restlessness increased respiration and insomnia.

INTERVENTION AND TREATMENT OF SUBSTANCE-USE DISORDER cont.

Long term maintenance without it intervention

programs attempts the persons from returning to the substance. ( Community Programs) 2. Self-Help Groups Eg. Alcoholics Anonymous (AA). A self help group designed to promote abstinence among alcoholics.

INTERVENTION AND TREATMENT OF SUBSTANCE-USE DISORDER cont.

3. Pharmacological Approach keeps the addicts from using certain substance. Eg. Alcohol treatment programs may include the chemical Antabuse to produce an aversion to alcohol. A person who consume alcohol one to two days after taking antabuse my suffer a sever reaction of nausea, vomiting and other discomfort. An addict also runs the risk of death if the consume alcohol while taking antabuse.

INTERVENTION AND TREATMENT OF SUBSTANCE-USE DISORDER cont.

4. Cognitive and Behavioral Approaches Aversion Therapy This is based on classical conditioning principles. The response to a stimuli is decreased by pairing the stimuli with an aversive stimuli. Eg. The abuser may be given agents that induce vomiting after smelling or tasting alcohol. After several accession they will desists from drinking because of the bad effect that they receive .

INTERVENTION AND TREATMENT OF SUBSTANCE-USE DISORDER cont.

Covert Sensitization Is an averse conditioning

technique in which the individual imagines a noxious stimulus in the presence of a behavior. Eg. Alcoholic patience are trained to imagine nausea and vomiting in the presents of alcoholic beverages. (Sue Sue Sue, 1997.)

DISADVANTAGES OF TREATING SUBSTANCE ABUSERS IN JAMAICA

Clients may feel less free while in rehab programs because they must follow certain rules or report directly to a therapist about their activities. 2. Another drawback is that clients have to live at the center rather than at home. This may cause them to be away from families and friends which may affect them adversely. http://addiction.utsandiego.com
1.

ADVANTAGES OF TREATING SUBSTANCE ABUSERS IN JAMAICA

Economic Benefits of Investing in Treatment Research

shows that every dollar spent on substance abuse treatment saves $4 in healthcare costs and $7 in law enforcement and other criminal justice costs. 10 On average, substance abuse treatment costs $1,583 per patient and is associated with a cost offset of $11,487, representing a greater than 7:1 ratio of benefits to costs. 1 Etner, S., Huang, D., Evans, E., Ash, D. R., Hardy, M., Jourabchi, M., & Yih-Ing, H. (2006) Interaction with other people who are recovering. Clients in inpatient programs are surrounded by other people who are trying to overcome substance abuse problems. This allows them to feel less isolated, which can help them overcome their desire to drink or use drugs.

BIBLICAL PERSPECTIVE
Romans 12:1
I appeal to you therefore, brothers, by the mercies of God, to present your bodies as a living sacrifice, holy and acceptable to God, which is your spiritual worship.

http://www.biblegateway.com/ Galatians 5:21

Envying, murders, DRUNKENNESS, revelings, and such like: of the which I tell you before, as I have told you in time past, that they which do such things shall not inherit the kingdom of god.

BIBLICAL PERSPECTIVE Cont.

It is much more difficult for a Christian/Sinner who is

enslaved to an addiction to come to know the God of the Bible. Notice the devastating consequences of drunkenness and how it offends our perfect God. (Shaw 2006. pg, 202.)

BIBLICAL PERSPECTIVE cont

God values our physical bodies. He considers our

bodies to be the temple, the dwelling place of the Holy Spirit. Eg Good Samaritan
The teaching of the Bible and miracles of Jesus show

that God cares about our physical health. (Omathuna, Larimore 2006 pg 53)

THANK YOU, THE END. ANY QUESTION?