Substance Abuse Services The Social Work Experience 5 th Edition Mary Ann Suppes & Carolyn Cressy Wells Chapter 8 This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; Preparation of any derivative work, including the extraction, in whole or in part, of any images; Any rental, lease, or lending of the program. © 2009 Allyn & Bacon

History of Social Work and Substance Abuse Issues 1917: M. Richmond developed an interview guide for Social Work in families with substance abuse problems. 1957: J. Sapir encourages Social Workers to change societal biases about alcoholism. 1970: NIAAA is created to support research related to alcoholism. 1971: CSWE publishes the first Social Work guide for educators to support development of courses on alcoholism. 1990s: Social Workers develop community-based treatment programs. © 2009 Allyn & Bacon

Social Work Roles and Substance Abuse As many as 70% of Social Workers include work related to substance abuse in their practice. Social Workers are part of the treatment team Assessment – Primary Alcoholism: “Lives to drink” – Secondary Alcoholism: Response to mental illness – Reactive Alcoholism: Response to trauma – DSM differentiates between abuse and dependence – AUDIT: Internationally used questionnaire © 2009 Allyn & Bacon

Social Work Roles and Substance Abuse (Cont.) Intervention – Customized to client needs, cultural background, and goals – Work with individuals, groups, and families – Monitor medications – Work in both in-patient and out-patient settings – Develop community prevention programs – Reach out to underserved and difficult to serve groups (e.g., homeless, mentally ill, poor) – Provide case management services © 2009 Allyn & Bacon

Government Resources for Prevention and Treatment NIAA and NIDA support research on prevention and treatment of alcoholism and drug abuse. CSAP focuses on prevention programs and operates the National Clearinghouse for Alcohol and Drug Information. SAMHSA provides funding for best practices in substance abuse treatment. School Social Workers implement prevention and intervention programs in public schools. © 2009 Allyn & Bacon

Harm Reduction Models Grounded in the strengths perspective Public Health approach to intervention Clients control decision-making Fewer drug addicts Needle exchange programs reduce HIV infection by as much as 30% Methadone treatment weans addicts off of Heroin © 2009 Allyn & Bacon

12-Step Programs Give control to a higher power Weekly self-help groups available worldwide Specialized for specific populations – Alcoholics Anonymous (AA): for alcoholics – Al-Anon: for family and friends of alcoholics – Al-Ateen: for adolescent children of alcoholics – Narcotics Anonymous: for abusers of narcotics and other drugs – Adult children of Alcoholics organization © 2009 Allyn & Bacon

Empirical Research Findings It’s important to consider what works, for whom, under what circumstances In-patient treatment followed by AA meetings is effective if chosen by clients Those with good intellectual functioning and a stable support network are likely to be successful in out- patient treatment. The Harm reduction approach works to reduce harm to the addict as well as those affected by the addiction. © 2009 Allyn & Bacon

High-Risk Groups Women who have been the victims of trauma need to be empowered; 12-step programs may not be effective. Unborn children of substance abusers are at risk for Fetal Alcohol Syndrome or the effects of drug withdrawal. Substance abusing youth are at risk for unsafe sexual activity, car accidents, drowning, and criminal behavior. Members of oppressed and discriminated groups often need specialized treatment that integrates cultural strengths and traditions. Those with mental illness need well coordinated treatment approaches. © 2009 Allyn & Bacon

Environmental Risk Factors Low home ownership is linked to high drug use–a measure of poverty Community participation and investment are protective against high drug use Social workers can advocate for policies that support urban development Harm reduction approaches include provision of drug “user-friendly” locations © 2009 Allyn & Bacon

History of the “War on Drugs” 1874: Women’s Christian Temperance Union (WCTU) is founded 1914: Harrison Narcotics Act prohibited the use of narcotics for non-medical purposes 1919: Passage of the 18th Amendment to the US Constitution prohibiting the manufacture and sale of alcohol (repealed in 1933) 1956: Narcotic Drug Control Act allowed the death penalty for selling heroin to minors 1970: DEA is created 1986: Anti-Drug Abuse Act created mandatory minimum sentences related to specific drugs © 2009 Allyn & Bacon