Brief Overview of Substance Use Disorder Joan Salmon, LCSW-R 05/22/2019
Working with communities to address the opioid crisis. • SAMHSA’s State Targeted Response Technical Assistance (STR-TA) grant created the Opioid Response Network to assist STR grantees, individuals and other organizations by providing the resources and technical assistance they need locally to address the opioid crisis . • Technical assistance is available to support the evidence-based prevention, treatment, and recovery of opioid use disorders.
Working with communities to address the opioid crisis. • The Opioid Response Network (ORN) provides local, experienced consultants in prevention, treatment and recovery to communities and organizations to help address this opioid crisis. • The ORN accepts requests for education and training. • Each state/territory has a designated team, led by a regional Technology Transfer Specialist (TTS), who is an expert in implementing evidence-based practices.
Contact the Opioid Response Network • To ask questions or submit a technical assistance request: • Visit www.OpioidResponseNetwork.org • Email firstname.lastname@example.org • Call 401-270-5900
Substance Abuse and Mental Health Services Administration (SAMHSA) Funding for this initiative was made possible (in part) by grant no. 6H79TI080816 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Approach: To build on existing efforts, enhance, refine and fill in gaps when needed while avoiding duplication and not “re-creating the wheel.”
Overall Mission To provide training and technical assistance via local experts to enhance prevention, treatment (especially medication-assisted treatment like buprenorphine, naltrexone, and methadone), and recoveryefforts across the country addressing state and local - specific needs.
Definition • Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. • Substance related disorders encompass 10 separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens; inhalants; Opioids; sedatives; hypnotics; anxiolytics; stimulants;
Definition • tobacco and other (unknown substances). • The substance related disorders are broken into two groups: substance use disorders and substance induced disorders. Substance induced disorders maybe classified by the following conditions withdrawal, intoxication and other substance/medication mental disorders.
Treatment Modalities • There are many levels of treatment available to treat an individual with a SUD. • 28 Day Rehabilitation- intensive treatment in short duration • Detox- Medically supervised withdrawal treatment • Residential- 24 hour facility where patients receive intensive rehabilitation related to SUD for a longer duration • Outpatient- Medically supervised treatment on an ambulatory basis.
Treatment interventions • Motivational interviewing - a counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior. It is a practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes.
Treatment interventions • Cognitive-Behavioral Therapy (CBT) – was developed as a method to prevent relapse when treating problem drinking, and later it was adapted for cocaine-addicted individuals. CBT strategies are based on the theory that in the development of maladaptive behavioral patterns like substance abuse, learning processes play a critical role. Individuals in CBT learn to identify and correct problematic behaviors by applying a range of different skills that can be used to stop drug abuse and to address a range of other that often co-occur with it.
Treatment interventions • Contingency Management Interventions/Motivational Incentives – Research of contingency management principles have demonstrated its effectiveness. This approach involves give patients tangible rewards to reinforce positive behaviors such as abstinence. • Relapse Prevention- Relapse is a process not an event. In order to understand relapse prevention you have stages of relapse and the triggers associated with it. • https://youtu.be/FmjjxdDwOIc
Barriers To Treatment • Stigma associated with SUD • Clinicians own perception of SUD • Patient motivation and commitment to the treatment process. • Insurance • Homelessness • Unable to access treatment • Cultural biases