Drug Addiction and treatments

Being a paper presented by Aguiyi Henry, at the monthly lecture with the NYSC- CDS Drug Free Club Kaltungo.

 

Good morning ladies and gentlemen, my brothers and sisters, the theme of my topic today is:
Drug Addiction and treatments.


Considering drug counseling as one of the best intervention technique to control drug addiction problems within our immediate environ.

Drug Addiction and treatments
Before driving further into our gradual procession on how drug treatments works in this very homily, I pray you permits me to imbue in, this very quote to stir up our discussions –

It says and I quote;- the cock crows only when he sees the light ,put him in the dark it will never crow ,today I have seen the light and am crowing ………………….

By Mohammed Ali,
The Heavy weight boxer.

Hopefully with our discourse today ,I believe that we will all see more lights on how drug treatment and counseling works and at the end may turn up to be better drug counselors ourselves ,in our own very little ways.

We have already said so many things on drugs abuse and addictions in this very forum before, with all their copious problems, they causes our society. However, to me I think, is the right time we should start regarding drug addictions as a serious health problem and to see how best drug counseling can serve as part of the solution approach to all addiction problems.

Some explanations have been presents by several schools of thoughts, to explain addiction in general terms. The moral explanation states that addictions are as the result of human weakness, and are defects of character.
 The disease explanation holds that addiction is an illness, and that it comes about because of the impairment of healthy chemical or behavioral processes.
The genetic approach states that there is a genetic pre-disposition to certain behaviors.
The cultural approach recognizes that the influence of culture is a strong determinant of whether or not individuals fall prey to certain addictions.
The blended model attempts to consider elements of all other models in developing a therapeutic approach to addiction and dependency. It holds that the mechanism of dependency is different for different individuals, and that each case must be considered on its own merits.
While not everyone agrees on what constitutes an addiction, in general, it is recognized that an addiction can be of any substance (for example alcohol, amphetamines, Drug Alcohol Abuse, cocaine, nicotine, opioids, sedatives, hallucinogens, inhalants, cannabis, phencyclidine, caffeine, and a wide variety of other substances), which, when ingested, cross the blood-brain barrier and alter the natural chemical behavior of the brain. It is also accepted that addiction includes dependency on “things” as well as substances, such things as gambling, eating etc.

In general, the term addiction, describes a chronic pattern of behavior that continues despite the adverse consequences that result from engaging in the behavior. Many substances and behaviors that provide either pleasure or relief from pain pose a risk of addiction or dependency.
Drug Addiction as we all know, is the constant longing for drugs.
Addiction means that the use of psychoactive drugs has changed the brain of the drug user, so that it begins to demand for drugs. The addicted brain needs drugs the way the healthy brain needs natural food and sleep. The use of addictive drugs upset the way the brain controls the senses, movements, thoughts, and emotions. People addicted to drugs depend on them to feel normal and avoid the painful symptoms of withdrawal. Drug addiction is a sickness and a serious health challenge. To recover from it, the addict first needs to admit that he or she does have a drug problem and then seek help from family, friends, doctors and counselors.

In the other hand, When these body and brain of an addict needs drug to avoid feeling sick. One way to differentiate the types of drug addiction is to consider two categories of dependence. First, is physical dependence, characterized by symptoms of withdrawal, and second is psychological dependence.
Physical dependency on a substance (Drug Alcohol Abuse) is defines by the appearance of characteristic withdrawal symptoms when the drug is suddenly discontinued. Thus, the state in which the body is adapted to the presence of a particular drug. When the administration of the drug is discontinued, intense physical disturbances like muscular pains, body itching, involuntary muscular action, nausea, etc. will manifested, depending on the drug type (Opiates, cocaine, barbiturates, hallucinogens, benzodiazepines, barbiturates, alcohol, nicotine, and a variety of more modern synthetic drugs are all well known for their ability to induce physical dependence and addiction).
While physical dependency can be a major factor in the psychology of addiction, the primary attribute of an addictive drug is its ability to induce a ‘high’ while causing harm to health of the individual.
The speed with which a given individual becomes addicted varies with the type of addiction, the frequency of addictive behavior, and the individual for example, some alcoholics reports that they exhibited alcoholic tendencies from the moment of their first intoxication from Drug Alcohol Abuse, while most people can drink socially without ever becoming addicted. Because of this variation, some people hypothesize that physical dependency and addiction are in large part genetically moderated. Nicotine and caffeine are two of the most addictive psychoactive substances.

Psychological dependence, on the other hand, is a condition in which a drug produces a feeling of satisfaction and a drive to keep using it continuously or periodically to get the desired pleasure and avoid discomfort. Briefly, a person dependent on drugs needs them to avoid the painful, symptoms of withdrawal.
Psychological addiction, as opposed to physiological addiction (Drug Alcohol Abuse), is a person’s need to use a drug or engage in a behavior out of desire for the effects it produces, rather than to relieve withdrawal symptoms. Instead of an actual physiological dependence on a drug, such as heroin, psychological addiction usually develops out of habits that relieve symptoms loneliness, anxiety, depression and feelings of worthlessness. As the drug and/or behavior is indulge, it becomes associated with the release of pleasure and avoidance of pain, and a cycle started that is similar to physiological addiction. This cycle is often very difficult to break. It is quite common for an addict to express the desire to stop the behavior, but find that they are unable to stop the addictive behavior.
Psychological addiction (Drug Alcohol Abuse) can theoretically form for any rewarding behavior or as a habitual means to avoid undesired activity. The most common of the psychological addictions include dependency on such things as gambling, eating, sex work, internet use and shopping and spending money. It is possible to be both psychologically and physically addicted at the same time.

 Alcohol addiction, the powerful craving for alcohol which often results in the compulsive consumption of alcohol, is one of the most widespread and costly addictions in our society.

The causes of its craving as popular beliefs are that it is:
1. Chemical or nutritional imbalance;
2. Genetic predisposition;
3. Neurological effect caused by runaway learning mechanisms; or
4. Inability to curb one’s own desires for enjoyment.
Psychological addiction of Alcohol Abuses is also involved in alcoholism since many alcoholics believe that they gain benefit from the use of the substance.

 They may believe that the alcohol improves their ability to socialize, helps them handle pressure, and allows them to feel superior to others in that they can handle extreme intoxication, or that drinking allows them to fit into their peer group. These effects all contribute to a person’s impression of the beneficial effects of alcohol in his/her life, and may result in a denial of the negative effects. It is important to recognize that many of these benefits can be real, not imagined. The person must be convinced of the net negative value of alcohol in their lives before any treatment can have meaningful lasting effects. An inability to stop drinking despite a clear understanding of alcohol’s negative balance of effects on his or her life is a primary indicator that a person suffers from alcoholism.

 So when a drug abusing individual got to this very stage of high addicts, we assumed that the very individual drug problems has gotten into the secondary or tertiary stages of interventions, what I mean is that :

A. Secondary Interventions stage
This stage treatment for drug dependent persons means that such individuals need to be confined in a treatment centre, where he or her will go through detoxification, counselling and, in most cases, drug therapy. Early intervention measures employed when a drug abuse problem begins to develop also falls under secondary preventions. Examples are counselling, and referral services offered by our Agency to clients brought in from various sources.

 B. Tertiary Interventions stage
Intervention at this stage has to do with rehabilitation and social re-integration of treated drug dependent persons. The main goal here is to provide support for clients in order to facilitate their rehabilitation and getting back into the mainstream of society, e.g., family, work, school, etc. Family members of clients have a major role to play in this regard.

TREATMENT AND REHABILITATION

 Treatment: This is an organized means of assisting drug dependent persons either in a hospital setting or outside the hospital with the aim of making the patient recover his or her normal status and state of health.
Professionals such as medical doctors, psychiatrists, nurses, psychologists, counselors, law enforcement agents and social workers, render this assistance; their aim is to stabilize the client under a well-planned treatment programs while Rehabilitation is the process of improving the residual functional capacity of the drug dependent addict person. Such that the individual can resume his or her expected role within the society.
 Due to the adverse effects of drug abuse on the dependent, rehabilitation assists the treated individual to recover those lost capacities caused by drug dependency.
 Rehabilitation aims at assisting the drug dependent individual reintegrate into the community as a productive person.

Detoxification in the other hand is a medical process by which the body of a drug dependent person is free from a substance of abuse, while treating any physical complications that develop from severe withdrawal symptoms. Detoxification may take a few days or weeks, depending on the drug of abuse, the severity of the problem, and the individual’s peculiar circumstances. During this period, patients usually stay in a specialized residential treatment facility or a separate unit within a general or psychiatric hospital. Detoxification, therefore, can be view as a process whereby the patient or client is stop from using of drug of his choice with either drug substitution or cold turkey.

While considering drug counseling as the best intervention and most affordable approach to drug problems, With the W.H.O. estimations that 23.5 million people may have suffered from substance abuse issues as back as 2009. Drug abuse counselors are a necessary part of the workforce Of the 23.5 million, but only 2.6 million receive treatment in specialized facilities according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Survey on Drug Use and Health. Drug abuse counselors are an integral part of the substance abuse treatment industry.

 May work in places such as:
• Research facilities
• Educational centers
• Hospitals
• Mental health facilities
• Methadone clinics
• Private practice clinics
• Detention centers
• Drug rehabilitation centers
• Detox centers

Drug Abuse Counseling:
Means the helping relationship or a face- to- face interaction between the individual with drug problem (client or counselee) and a professional helper (counselor), who will assist the counselee overcome his or her drug problem. That is to say, that drug abuse counselors specialize in the treatment and recovery of substance abusers. They work with people suffering from dependencies on any type of drug ranging from cocaine to marijuana etc.

Why Counseling Is Important in Addiction Treatment
Opioid addiction is more than a physical dependence on drugs. Even after detox, when physical dependence is cure, addicts are at high risk for relapse. Psychological and social factors are often powerful stimuli for prescription drug abuse relapse:

• Stress, especially sudden life stresses
• Hints or clues from the environment, like visiting a neighborhood
• Social networks, like spending time with friends who continue to use drugs

 These factors can create ongoing, nearly irresistible urges to use drugs. Prescription drug counselor helped the addicts escape craving and learn to cope with life, without using drugs.
Several counseling therapies are available for prescription drug abuse; no method is known to be the best. Likewise, no one approach is appropriate for everyone with opiate addiction. The right drug abuse treatment plan; is tailored to a person's addiction and his or her individual needs.

Counseling Objectives
(i) To assist clients to realize their current situation and the factors that have made such problems persist.
(ii) To assist them to understand self, interests, and the abilities and capabilities they have in resolving their difficulties.
(iii) To teach them skills that are lacking and that will assist them in the process of adjustment and growth towards self-actualization.
In drug counseling, the client learns of his personal attributes that are assets to his development in any area of human undertaking.
What does a drug abuse counselor do in nutshell?
A drug abuse counselor works with the drug user in a therapy setting. His or her purpose is to find the root of the addiction and help patients progress into sobriety. Depending on the underlying cause of the addiction discovered, the counselor develops an individual treatment plan for each patient. To help their patients work past the addiction, counselors educate them about addiction and teach them how to move on through life without substance abuse. The main goal of a drug abuse counselor is to guide the drug abuser into moderations through counseling.

TYPES OF COUNSELLING
• Individual Counseling: This is a one-to-one relationship involving only the counselor and the client. The process is strictly confidential.
• Group Counseling: This involves two or more people with similar or different problems but are seeking help together, e.g., peer counseling. Group counseling enables members to appreciate their individual problems in relation to those of others and develop insight into new ways of seeing things once the veil of addiction is removed from their sub-conscious mind. It also offers the group opportunities to constructively criticize for attitudes and behaviors that are contrary to rehabilitation goals of the individual and group.
• Family/Parent Counseling: Because the family is at the center of the client’s upbringing, what affects a family member affects the family. Family Counseling helps the members understand and cope with the situation and enlist their support in achieving recovery goals of a drug dependent family member. By doing so, a tension is reduced and everybody becomes part of the rehabilitation process.

Qualities of a Good Counselor:

 A good Counselor must possess the following qualities.
(a) Is a good listener
(b) Is honest, genuine and sincere in dealing with drug abuse clients
(c) Allows clients the right to make their own choices and goals without imposition.
(d) Maintains a client’s confidentiality
(e) Has a good personality presentation
(f) Respects and accepts the feelings, emotion and experiences of clients.
(g) Ability to mediate and resolve conflicts among participants.
(h) Ability to be focused, to confront contradictions as well as to reward efforts and achievements.
(i) Must be trained in the art of counseling with good application of psychological skills in test instruments, administration and analyses.

Treatment for drug abuse is different for each patient and can include some combinations:
A. Motivational interviewing
B. Contingency management
C. Cognitive-behavioral therapy
D. Family therapy

 Motivational interviewing is a type of therapy that prepares individuals to change from the regular behavior and accept treatment for their addictions.
It is a much-focused activity and requires the drug patients to explore their own behavior and recognize where change is needed.
It is used to help the user realize that change needs to be made on his or her part to get better and live a sober lifestyle.
Contingency management is a type of positive reinforcement counseling that encourages the patient to abstain from drug use.
When a progress is achieved, the patient is reward for his or her efforts, and on the contrary, when he or she regresses, a punishment is incurred and the reward is withheld.

 Cognitive-behavioral therapy is a plan that leads patients to understand and avoid situations that are most likely to influence them to use drugs.
It also teaches coping skills to the patient. The process teaches the user to recognize negative thoughts, triggers and emotions and then have an acceptable response that excludes the use of drug. It is an extremely important therapy step for drug abusers.

 Family therapy is also called multi-dimensional family therapy. It is use to improve the functioning of a family as well as address influences that may be pressed on the patient from the family as well as address influences that may be pressed on the patient from the family unit.
This approach involves the family of the user in treatment by working with each member alone and the family together as a unit. Family therapy is essential for the treatment of youth users.

 How the drug abuse counseling do his or her work?
When the counselor first meets the drug addict, he or she will discuss with the client about his or her addiction as well as his past.
The counselor will attempt to get to know who he is and what may have caused the substance abuse. Through treatment, he or she will discover the most suitable way for the client to lead him or her into a more sober living lifestyle, with each meeting fine –tuning their plan of recovery.

 A drug abuse counselor will help you identify the client addiction-related behavior patterns and help him or her confront those behavioral and emotional issues that may be hindering his or her progress. Some sessions will be easier than others will, but each session comes more progress.
What does family need to do when a member is under-going counseling?
Another key role of drug abuse counselors is to work with the families of patients as the user moves through treatment. In addition to providing their loved one with individualized care, they educate the family on treatment, drug information and the progress of their loved one.

 Studies have shown that family bonding programs are particularly effective with patients, as they promote a healthy home life and offer preventative education to other members of the family unit.
 A family can better deal with the addiction and achieve ultimate sobriety if they are knowledgeable.

What else do the Drug counselors do?
Their job does not end when you loved one leave their office. Drug abuse counselors also help arrange additional mental health treatment and healthcare that may be needed. They may consult with psychiatrists and psychologists if they suspect an underlying mental condition and then refer you to their services for care in needed. Some may recommend impatient care at a substance abuse residential center if they believe it is best for the patient. Counselors are trained, to think beyond the counseling session and always make treatment decisions in the patient´s best interest.
Individual vs. Group Therapy
While any counseling therapy for drug abuse treatment is better than none, group therapy is generally preferred over individual therapy. In group therapy, a person is more likely to be both challenged and supported by peers who are also going through drug rehab. Twelve-step programs like Narcotics Anonymous are the most known group therapy organizations.
Individual therapy can be helpful in the case of a dual diagnosis: coexisting depression, bipolar disorder, or other significant mental health condition that requires treatment in its own right, separate from the opioid addiction.

Outpatient vs. Residential Treatment
Residential therapy allows the addicted person to temporarily escape, the environment that allowed him or her to use drugs. A person goes away to a specialized facility for a period of weeks to months. While highly effective in the short term, there is debate as to whether residential programs lead to longer abstinence from prescription drug abuse than outpatient programs. Residential drug abuse treatment program are very expensive, usually costing tens of thousands of dollars.

 Outpatient treatment programs are the usual setting for ongoing prescription drug abuse treatment.
Rehabilitation: The process of recovering those capacities and abilities, which have reduced or lost-out due to drug abuse. The aim is to enable treated drug dependent persons acquire necessary skills to make them self-reliant and live normal lives in the community. (See the topic on Treatment and Rehabilitation

Social Reintegration: This is the final stage of the rehabilitation process. It involves bringing the recovered drug dependent person into the main stream of societal activities, thereby removing the social stigma that society may have on such a person.

Relapse and Relapse Prevention: - Relapse is a situation whereby a recovering drug dependent person starts to use drug again after a period of abstinence, while relapse prevention is a process of ensuring that the recovering addict does not go back to the drug use habit.

The following factors can bring about relapse:
(I) Nature of the drug;
(ii) Improper treatment and rehabilitation process;
(iii) Inadequate treatment and rehabilitation facilities;
(IV) Lacks of family support
(v) Psychological make-up of the individual.

To prevent relapse, all these issues must be properly addressed. Briefly, all stakeholders should give adequate support and understanding to the recovering client.

After-Care: This refers to services that are available to clients in the later stages of recovery. It denotes measures to stabilize the client through various measures that may include drug education and recreational activities.

Follow-Up: Follow-up is a process of putting the client into checks to control the possibility of relapse. This usually involves monitoring the recovered patients and collecting information about them long after they graduate from rehabilitation programmer. This may take the form of home visits or asking the client to report to the counselor for observation.


Counseling Stages/Processes.
Usually six main stages are involved in the counseling process that has to start and end in an orderly manner.
1. Structuring
This is the first contact between the counselor and client. Here the framework for the interaction between the counselor and client is set. That is, both parties agree on TIME, DURATION and FREQUENCY of counseling sessions. The ROLES of both counselor and client is to carefully spell out and the bounds of CONFIDENTIALITY discussed as well as CLERKING/HISTORY TAKING done.

Format for History Taking
A - Bio-Data: Name, date, age, addresses, phone nos., religion, marital status and next of kin.
B - Educational qualifications, with dates.
C - Work History: Employed, unemployed, satisfaction on job, duties and responsibilities as well as relationship with boss and co-workers.
D - Medical History: Diseases suffered and previous hospitalization and treatment obtained.
E - Family History: Family type (monogamy, polygamy, single parent, etc.).
Name of parents, occupation and addresses.
Status (dead or alive)
Relationship between parents and client as well as between parents themselves, and between client and other siblings
Birth order in the family. Names and occupations of relatives.
F - Social History: Roles in the house
Family attitude towards client
Neighbour/Community attitude
Interest/Hobbies.
G - Drug History: - Drug used, method of use, and reasons for abuse
- Duration of use.
- Motivational factors (feelings after use, factors encouraging use, attempts to stop, and difficulties encountered).
 - Relapse, when, why, and how?
H - Case Diagnosis - Determine the real problem of the client and any physical or psychological impairment observed.


   This involves assessment of the problem and the client’s needs. This is to identify:
A - Social and behavioral contingencies that leads to and promote client’s abusive behavior.
B - Alternatives within the clients’ behavior repertoire that can remove the antecedent contingencies.
Psychological test instruments can also be administered at this stage.
3. Treatment Goals
Definition and setting of counseling goals is done at this stage. Counseling goals are then defined and set because of painstaking assessment and history taking procedures. An action plan is then worked out between the counselor and client.
4. Intervention
In Intervention, the client with the active and empathic support of the counselor implements the action plan. This is usually accomplished through role modeling, bargaining, and reinforcement techniques and where necessary, tutoring as is the case with coping skills training.
5. Termination
Is the point at which the drug problem is fully or partially solves and the client takes leave of the counselor? It is important that the drug abuse client be assured that he/she is always welcomed in the future, where follow-up is not necessary.
6. Follow-Up
This is to ensure that the goal achieved during the counseling period is well maintained.

THE SIX POINT THERAPEUTIC PROCESS
But for the unprofessional concerned individuals, who wants to help in achieving drug addiction consoling and treatment goals can apply— the six point therapeutic process in handling addicts through one on one connections, well-articulated cure program and painfully patient cares and understands through the following steps

 First Stage: -Addict must admit to himself that he is into drugs and for him to realize why he always-on drugs cause addicts takes to junk to escape something.
Second Stage: - Teach him or her, why he/her is using narcotics and other hard drugs and for him/ her to understand that he/she is spending too much on drug, which only enrich the drug barons more and more.
Third Stage: - let him know there are ways out to he can exploit to stop his or her addiction problems.
Fourth Stage: - Addictions shatters self-images and ego, build him up until he realized that he had within him a self-power to end his addictions by improving him mentally, to discover his self-pride.
Fifth Stage: - The addict should voluntarily undergo a cold turkey break with drug, which means enduring the physical agonies of abruptly quitting hard drugs.
Six Stage: - Always eliminates what so often defeats the average social addicts hostilities and suspicion by replacing his addicts bodes with something else, like exposing him/her to some other social situation among proud and clean people like churches, debating and sports clubs, who shows each other mutual affections and respect instead of the familiar hostility of the street life which will help him to feel the effects of self pride.

With all the above, profound techniques for drug treatments and counseling, I hope that we can now all comfortably step-out there, to confront the raising menace of drug addict problems within our homes and immediate environments.

 Finally, if we as individual can at least help e person out there to quite drug addiction, I bet you that individual will never forget you for standing with him during his time of need, redemption and final recue from special hell of drug addictions

Thank you for listening to our very message of hope……………………………..