Addictions

Social worker can help in the evaluation of addictions and treatment. Termination of use may be seen as the highest level of success but really any change in bx should be viewed as a success. This could be greater control over bx, improved family relations, better job performance, increased self-image, and greater use of other coping strategies when confronted with triggers.

Substance abuse and/or dependence – puts drug as the most important thing to them subconsciously or consciously.

Phases:

a)                  Precontemplation – addict in denial “no problem!” Worker proved clident information about how the bx is physically or emotionally affecting them based on observations and consequences (warm and supportive). Like any bx that is being changed, rewards can be utilized when bx is reached

b)                  Contemplation – addict tries to decide to change bx or not

c)                   Preparation – discusses change, experiences stress b/c of the cost associated with quitting or not quitting. Social worker can help by providing more information about how to make the changes and the outcomes of the changes

d)                  Action phase – help client find alternative coping strategies to deal with triggers and urges like written journal of how well they are controlling bx. Set small targets so that they are achievable and the client doesn’t feel like giving up so easily, set up incentives

e)                    Maintenance – keeping sobriety

   The effects of drugs and alcohol on behavior – People’s bx tends to change when effected by drugs and alcohol. Some become like zombies while others are more aggressive.

The effects of substance abuse and/or dependence on relationships – relationship problems (problems in communication b/c usually those who are addicted have to lie in order for significant other not to yell or be affected), child and spouse abuse (from increased aggression), divorce. Usually the relationships are effected b/c the bx of the person has changed due to the addiction/substance.

The effects of substance abuse and/or dependence – deteriorating health, car accidents, loss of job, low self-esteem, loss of social status, financial disaster, arrests and convictions 

                  One can be physically dependent or psychologically dependent (or both) on a substance. If they are physically dependent, they tend to re-engaged due to the withdrawal symptoms that they experience when not using the drug. These withdraw symptoms can be severe but usually start out with shaking hands, sweating, sometimes causes disorientation, and many need medical attention to assure safety when in withdrawal. If someone is psychologically dependent, they use more for the achieved mental state- whether that is to block depression, anxiety, trauma, etc.  

       Addiction theories - This can be viewed as a disease b/c research indicates that some ppl are born with a vulnerability to drugs. However, addiction may also be learned if one observed others repetitively engaging in that behavior. Also, ppl use drugs to cope with stress and anxiety.

Other addictions – eating disorder, gambling - all addictions can have the same effect on bx and relationships. Bx becomes obsessive and the most important thing is the addiction and fulfilling that urge to engage in the bx or drug. As plans are ignored and promises broken, relationships falter until the client feels a sense of isolation in which they try to alleviate with the addiction again.

Levels of Treatment: outpatient, intensive outpatient, intensive care (usually in-patient short term), residential facilities (unusual for MCOs to pay for)

Sands, R.G. (2001). Clinical social work practice in behavioral mental health: a postmodern approach to practice with adults. Pearson Education Company, MA.