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Substance Abuse Issues

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Title: Substance Abuse Issues


1
Substance Abuse Issues
  • A training for Human Service Providers
  • Enter Date Here

2
Ground Rules for the Day
  • Start and Stop on Time
  • Maintain Confidentiality
  • Participate fully and encourage participation of
    others
  • Respect others viewpoints, opinions and needs
  • OK to voice concerns and questions
  • Make comments in a constructive manner
  • Silence cell phones

3
Welcome
  • Substance use impacts many families
  • Consider mental health, trauma, basic needs
  • Safety among home-visitors
  • Safety among families
  • Actions that can and should be taken
  • Building relationships
  • Identifying help and helping

4
Presentation Goals
  • Review local data on substance use prevalence
  • Introduce issues related to substance use
  • Reduce stigma associated with substance use
  • Identify signs and symptoms of substance use
  • Screen and referral/intervention tools
  • Increase participant ability to match client
    needs with eligible services
  • Identify Substance Use Disorder Treatment
    Services in our community

5
Substance use in Greater Lansing
  • Data from Tri-County Metro
  • Data from ISAP Coalition
  • Alcohol is the most commonly used and abused
    drugs
  • Getting more common marihuana (medical), heroin
  • Equally bad in all of our community

6
Alcohol is the Most Common Drug of Abuse
  • Binge Drinking Defined
  • Women more than 3 drinks on any single day AND
    more than 7 drinks per week.
  • Men more than 4 drinks on any single day AND
    more than 14 drinks per week

7
Percentage of Adults Who Report Binge Drinking in
the Past 30 Days
8
Students Who Report Binge Drinking in the Past
Two Weeks
9
Percentage of Students Who Have Had At Least One
Drink of Alcohol
10
Students Who Report Ever Smoking Cigarettes
11
Marijuana use continues to rise among U.S. teens,
while alcohol use hit historic lows
  • Marijuana use among teens rose in 2011 for the
    fourth straight yeara sharp contrast to the
    considerable decline that had occurred in the
    preceding decade. Daily marijuana use is now at a
    30-year peak level among high school seniors.
  • Synthetic marijuana, which until earlier this
    year was legally sold and goes by such names as
    K2 and spice, was added to the studys
    coverage in 2011 one in every nine high school
    seniors (11.4) reported using that drug in the
    prior 12 months.
  • Alcohol useand, importantly, Binge
    drinkingcontinued a long-term gradual decline
    among teens, reaching historically low levels in
    2011.
  • Energy drinks are being consumed by about one
    third of teens, with use highest among younger
    teens.

12
Regional Illicit Drug Forfeitures
  • 2011 Narcotic Seizure Value 4,046,431
  • Tri-County Metro Narcotics (MSP)
  • ? Heroin Pills (opiates)
  • ? Marihuana (Marijuana)
  • ? Methamphetamine
  • ? Alcohol
  • ? Tobacco

13
Prescription Drug Abuse
  • Taking medicine that was not prescribed to you,
    or us being take for non-medical use
  • 60 from a friend or relative
  • 8 purchased from a friend or relative
  • 4 taken from a friend or relative
  • 17 physician prescribed

14
Addiction
  • The use of substances as a means to cope with
    difficult experiences is common
  • Use of substances can lead to addiction, in which
    the need for the alcohol or drugs is physical
    becomes the most important thing in someones
    life
  • People who are using have a harder time keeping
    themselves and their families safe

15
How is having an Addiction like having Cancer?
  • Biologically pre-disposed
  • Most likely addicted before adulthood
  • Family history and normalization of use
  • Trying to find a normal brain function
    (self-medication)
  • Some brain responds stronger to drug use
  • Power/Control Dynamics
  • Victims are by-products of wealthy suppliers

16
Drug Use Why?
  • Mental Health Diagnosis (50 use drugs)
  • Trauma (Seeking Safety)
  • Family inter-generational use
  • Genetic and Biological Factors
  • Escape from the pain of reality
  • Medical or Disease Model is Most Effective
  • Use / Abuse /Dependence

17
Substance using behaviors
  • Sexual assault
  • Childhood or current
  • Physical assault
  • Domestic violence

18
Addiction Pathology
Child of a substance abuser
Child of an alcoholic becomes an alcoholic
Substance abuses -Phases
Recovery
Relapse
19
Addiction in the Brain
20
Addiction in the Brain
  • Neurotransmitters are chemicals in the brain that
    relay, intensify and alter signals between
    neurons and other cells. When someone takes an
    addictive drug, whether it be alcohol, cocaine,
    nicotine, heroin, or Valium, just to name a few,
    the brain gets flooded with a neurotransmitter
    called dopamine.
  • This neurotransmitter is related to feelings of
    pleasure and excitement, and is associated with
    the reward center of the brain. In a normal
    brain, dopamine is released when the person
    experiences pleasure.
  • However, chronic use of addictive substances
    means that the brain begins producing less
    dopamine on its own since its so used to getting
    flooded with dopamine as a result of the
    addiction. This leads to the abuser being unable
    to experience pleasure from his normal life, thus
    creating a dependency on the drug to feel
    pleasure.

21
Human Needs Brain Tricks
22
The Illness Brings with it Frustrating Behavior
  • Deceptive, lying, secretive
  • Passive-Aggressive Characteristics, failure to
    follow-through with responsibilities
  • Failure of priorities, chronic tardiness, money
    problems, lack of judgment, anxiety, depression
  • Disregard for themselves or values of those they
    love, poor boundaries
  • Legal implications

23
Blanket Activity
  • Strengths/Assets
  • Social Justice
  • Balance/Independence
  • Intimacy closest
  • Friendship community
  • Participation clubs/groups
  • Exchange paid help

24
(No Transcript)
25
Marihuanamost common illegal drug
  • Signs Symptoms
  • Animated behavior, sleepy, dilated pupils,
    bloodshot eyes, loss of coordination, odor,
    paranoia, fragmented thought.
  • Usage
  • Smoked in joints, pipes, bongs, or blunts. Can
    be mixed in food or brewed in tea. Change lasts
    3-5 hours or until the next day.
  • Slang
  • Mary Jane, pot, reefer, skunk, weed, yerba,
    bluns, dope, ganja, grass, herb, hydro, kif, bud,
    boom, and 420.

26
MarihuanaMichigan Medical Marihuana
  • Federal Law trumps State Law
  • Caregiver and Patient Cards Issued by State of
    Michigan, Licensing And Regulatory Affairs
  • Caregivers may grow up to 72 plants in an
    enclosed, locked facility
  • Patient limit is 12 plants per Patient
  • Safety in homes is primary concern
  • Marihuana is active in the body for 7 hours
  • Impaired Driving is increasing

27
Marihuana
28
K2/Spicealternative to marihuana
  • Signs Symptoms
  • Rapid heart rate, high blood pressure,
    hallucinations, delusions, paranoia, changes in
    perceptions and behavior, seizure and death.
  • Usage
  • Leafy herbs with psychoactive chemicals sprayed
    on and then smoked. Chemical changes make some
    forms illegal, some legal.
  • Slang
  • Incense, potpourri, Spice, K2, K3, fake pot,
    Chemical Compound is JWH-018 and not THC.

29
MethamphetamineOne Pot Meth Labs urban/rural
  • Signs Symptoms
  • Dilated pupils, euphoria, rapid speech,
    depression, violent, nasal congestion, insomnia,
    weight loss, dry mouth, lack of interest in food
    and sleep. Skin abscess, paranoia, volatile mood,
    movement disorders, lead poisoning, and
    meth-mouth.
  • Usage
  • Smoked, snorted, taken orally or injected.
    Ingestion produces euphoria for 12 or more hours.
    The One-Pot Meth Lab has increased use, and
    brought meth into cities. Pacifiers and glow
    lights supplement use at Raves.
  • Slang
  • Speed, chalk, crank, ice, glass, meth, shards,
    speed, stove top, tweak, yaba, yellow bam, glass,
    crystal, go-fast, ecstasy, rollin, E, X.

30
MethamphetamineManufacturing Products
  • Signs Symptoms
  • Chemical smell in home and on person. Multiple
    chemicals - together in kitchen or garage used
    for cooking meth.
  • Combination of several household products may
    indicate Cooking Meth
  • Batteries, camp fuel/gasoline, lye, drain
    cleaner, allergy medicine containing
    pseudoephedrine or ephedrine, plastic bottles,
    tubing, match heads

31
Prescription Drug AbusePills not prescribed to
you
  • Signs Symptoms
  • Pinpoint pupils, nausea, drowsy, confused,
    relaxed, blood pressures high or low, heart rate
    and respiration high or low. Anxiety, euphoria,
    depression, irritable, shaky, trouble sleeping,
    coma. Tolerance
  • Usage
  • Pills can be swallowed, crushed, snorted
    injected. Pain patches. Pharm Parties/Skittle
    Parties mix stimulants, narcotics and
    depressants. Pain pills should not be combined
    with alcohol, antihistamines or benzodiazepines.
  • Medication Suppliers
  • Most Prescription Drugs come from your medicine
    cabinet. Properly dispose of all expired, un-used
    and un-wanted medications. Visit
    www.michigan.gov/deqreswastecontacts for local
    collection programs.
  • ADD medications, pain pills and OTC pills are
    often combined with unknown outcomes.

32
Inhalants
  • Signs Symptoms
  • Drunk or disoriented appearance, paint or other
    stains on face, hands, or clothing, hidden empty
    spray paint or solvent containers, chemical
    soaked rags or clothing, slurred speech, strong
    chemical odors on breath or clothing, nausea or
    loss of appetite, red or runny nose, sores or
    rash around nose or mouth. Hidden empty
    containers. Nail polish, nail polish remover,
    perfume samples
  • Usage
  • Sniffed or Inhaled. Local deaths have occurred
    with first time use.
  • Slang
  • Huffing, bagging, buzz-bomb, laughing gas, poor
    mans pot, poppers, rush, snappers, and whippets.

33
Mandatory Reporters
  • Physicial Neglect
  • E. If the allegations involve parental drug use
  • How do you know the parents are using drugs?
  • What kind of drugs are they using?
  • Do the parents use drugs in front of the child?
  • Are the parents selling drugs out of the home?
  • Are the parents allowing other people to use
    drugs in the home or to sell drugs out of the
    home?
  • Mandated Reporters Resource Guide
  • (http//www.michigan.gov/documents/dhs/Pub-112_17
    9456_7.pdf)
  • Medical Neglect
  • Improper Supervision
  • Abandonment
  • Failure to Protect
  • Abuse Physical/Sexual

34
Continuum of Services Continuum of Need
35
Case Study 1
  • Father of baby (FoB) lives with Mother of Baby
    (MoB) in a rural community. FoB was previously
    shot in the leg, is disabled, and uses a wheel
    chair. He reports that he suffers from chronic
    pain, but refuses opiate painkillers. FoB has a
    medical marihuana card for his pain and grows his
    own marihuana. He does not provide caregiver
    services for others. The plants are kept in a
    locked closet and there is a water bong on top of
    the refrigerator. The home visitor has reported
    no smell of marihuana in the home at any time.
  • MoB has recently delivered her baby. She
    entered prenatal care at six months, and had
    received home visiting services to assist with
    medical coverage, transportation to medical
    appointments, and tangible needs. MoB has a
    history of substance use (heroin), but is in
    recovery and reports that she does not use drugs.

36
Case Study 2
  • Mother of Baby (MoB) is four-months pregnant and
    has three other children in the home (ages 12, 8,
    and 6). She receives food assistance, and lives
    with her boyfriend. He is on SSI and pays the
    rest of the bills.
  • MoB has participated in two previous home
    visits. Today, she enters the home visitors car
    with red glassy eyes and a light smell of
    marihuana. The home visitor asks if MoB is doing
    ok, since her eyes are red. MoB states that she
    was at Michigan Works all day looking at the
    computer screen.

37
Case Study 3
  • This same MoB is now requesting assistance in
    obtaining a birth certificate for one of her
    children. At the next visit, MoB gets in the
    car and says that she cant live with her
    boyfriend because he drinks alcohol and takes
    Vicodin daily. MoB reports that the boyfriend is
    a mean drunk and is verbally abusive towards her.
    She reports that he steals her money to buy
    alcohol, even when it means that she cant take
    the bus to go to Michigan Works.
  • MoB states that she probably should not judge
    him since she has a medical marihuana card for
    carpal tunnel syndrome. MoB braids hair to make
    pocket money and uses marihuana to ease the pain
    that it causes. MoB reports that she only uses
    marihuana if she is going to braid hair, and does
    not use it when the kids are around.
  • MoB states that she has not used marijuana
    during the four months of this pregnancy. She
    asks you for help finding other housing so she
    can leave her boyfriend.

38
Authentic Messages get Results non-violent
communication (NVC)
  • Empathetically listening
  • Observations
  • Feelings
  • Needs
  • Requests
  • Honestly Expressing
  • Observations
  • Feelings
  • Needs
  • Requests
  • Both sides of the NVC Model Empathetically
    listening and honestly expressing use of the
    four steps of the model
  • Observations, Feelings, Needs, Requests

39
Small Changes can make a Big Difference
  • Keeping Track
  • Counting and Measuring
  • Setting Goals
  • Pacing and Spacing
  • Avoid Triggers
  • Planning to Handle Urges
  • Knowing your NO
  • Find Safe Support

40
Best Practices Assess/ReferEvery Encounter
  • Varied Resources Offered
  • Genuine Concern and Care
  • Authentic Relationship
  • Motivational Interviewing
  • Capitalize on the Moment
  • Follow the Clients Lead its their life and
    their priority and readiness

41
Assessment and Interventions
  • CAGE Assessment
  • C Have you every tried to Cutback on your use?
  • A Have you ever been Annoyed/Angered when
    questioned about your use?
  • G Have you ever felt Guilt about your use?
  • E Have you ever had a Eye-opener to get started
    in the morning?

42
Local Collaboration
  • Power of We
  • http//powerofwe.org/
  • ISAP Coalition
  • www.drugfreeingham.org
  • Ingham Great Start Collaborative
  • www.inghamgreatstart.org
  • Care Coordination Center
  • www.ceicmhca.org
  • (888) 230-7629 or (517) 346-8458

43
Continuum of local services Home visitation
  • Capital Area Community Services
  • Early Head Start
  • Community Mental Health
  • Parent Infant Program (PIP)
  • Parent Young Child Program (PYC)
  • Ingham County Health Department
  • Family Outreach Services (FOS)
  • Public Health Nursing
  • Ingham Intermediate School District
  • Early On
  • Great Parents-Great Start

44
Continuum of local services Recovery meetings
  • Central Alcoholics Anonymous
  • http//www.aalansingmi.org/
  • Narcotics Anonymous
  • www.na.org
  • Smart Recovery
  • www.smartrecovery.org
  • Celebrate Recovery
  • www.celebraterecovery.com
  • Al-anon and Alateen (family/friend support)
  • www.al-anon.alateen.org

45
Continuum of local services Treatment options
  • Community Mental Health
  • www.ceicmhca.org
  •  Toll Free 1.888.230.7629
  • Local Calls (517) 346-8458
  • Hours 830- 430 (M-F)

46
Care Coordination Center Responsibilities
  • Screening, Referral, Follow-Up
  • Warm Transfers
  • Utilization Review
  • Next Day Openings
  • Care Management
  • List of Care Coordination Center providers
  • Resource Consulting

47
Care Coordination CenterEligibility
  • Medicaid, Adult Benefit Waiver (ABW), or MiChild
    Requirements
  • Resident of one of the following Counties
  • Clinton, Eaton, Gratiot, Hillsdale, Ingham,
    Ionia, Jackson, or Newaygo

48
Thank you!
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  • Agency
  • Email address
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