CHAPTER 1: Introduction to Substance Abuse Counseling

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

2. 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 21st Century • An Overview of This Book • Conclusion

3. 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

4. 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%.

5. 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.

6. 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-impaired-driving fatality occurred every 48 minutes

7. 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.

8. The History of Substance Abuse • Over the centuries, drugs have been used:

9. The History of Substance Abuse

10. 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.

11. Societal Costs of ATOD Use, Abuse, and Dependency

12. Societal Costs of ATOD Use, Abuse, and Dependency

13. 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

14. Substance-Related Diseases

15. 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.

16. 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.

17. The Profession in the 21st 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

18. 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.

19. Overview of Book • MyCounselingLab • 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

20. 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?

21. 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.