Genetics and Drug Abuse Essay

Pages: 10 (2814 words)  ·  Bibliography Sources: 8  ·  Level: College Senior  ·  Topic: Sports - Drugs

SAMPLE EXCERPT:

[. . .] " (Volkow, nd, p. 1) Because of the chronic nature of the disease, relapse to abuse of the individual's drug of choice is considered to be "not only possible but likely, with relapse rates similar to those for other well-characterized chronic medical illnesses such as diabetes, hypertension, and asthma." (Volkow, nd, p.1) Treatment involves the change of behaviors that are deeply embedded therefore relapse "should not be considered failure but rather indicate that treatment needs to be reinstated or adjusted, or that alternate treatment is needed." (Volkow, nd, p. 1) However, the individual who is addicted must also do their part and "take responsibility to get treatment and actively participate in it." (Volkow, nd, p. 1) Ethnicity is also reported to play a great role in the individual's development of chemical dependency. While the majority of those who are chemical dependent are non-Hispanic white individuals, there is a large population of Hispanic men and African-American men who are cocaine and crack addicted respectively. Also linked to alcoholism is Serotonin deficiency. It is reported that persistent use of drugs results in the brain employing "compensatory adaptations such as down-regulation and up-regulation to restore equilibrium." (Levin, Culkin and Perrotto, 2001, p. 116) Cultural tolerance is stated to impact the "availability of drugs and drug availability increases the potential for abuse." (Levin, Culkin, and Perrotto, 2001, p. 116) It is reported as well that there is a "greater metabolic tolerance for alcohol in high-risk subjects" and that high risk subjects as well "exhibit abnormal neuropsychological feature in terms of p300 wave and executive function deficits." (Levin, Culkin and Perrotto, 2001, p. 117-118)

III. The Disease Model of Chemical Addiction

The disease model is reported to refer to the idea that alcoholism and other drug addictions 'are biologically-based illness." (Levin, Culkin and Perrotto, 2001, p. 118) Ashery, Robertson and Kumpfer (1998) report that research on chemical dependency should focus on the following:

(1) Families are embedded in a social context. Measures and analyses should consider the impact of the broader context (neighborhood, school, and work) on the family and the effectiveness of prevention programming. To accomplish this, new measures and analysis strategies may need to be developed.

(2) Longitudinal studies of family interventions should use methods such as time series analysis to maximize understanding of family processes, dynamics, and changes over short and long periods of time.

(3) Interrelationships among variables such as parental monitoring, association with deviant peers, and academic achievement should be considered when designing a measurement plan for family-based prevention intervention research projects.

(4) Meta-analyses should be conducted to provide the statistical power necessary to identify various common components and pathways of successful family-based drug abuse prevention programs.

(5) Culturally sensitive measures should be employed in determining risk and protective factors specific to subpopulations with whom family prevention intervention are being used.

(p. 325)

IV. Model of Assessment, Intervention and Treatment

Because chemical dependency is often combined with psychological issues, the client in this scenario would be screened for potential psychological issues or illnesses. The model of assessment, intervention and treatment in this scenario will be the Chemical Dependency Disposition Alternative (CDDA) program which is generally used by juvenile courts as a sentencing alternative for youth who are chemically dependent. Assessment requirements include: (1) a structured clinical interview used for determining "DSM-IV diagnoses of substance dependence, abuse or use; (2) evaluation that is comprehensive in addressing the areas of history of substance use, medical health, developmental issues, school and vocational history, strengths or resiliency factors, conduct disorder behaviors, criminal involvement, psychopathology, such as depression and hostility, familial relationships, history of physical, sexual, or emotional abuse, peer relationships, current living conditions, sexual activity, and leisure activities." (Rutherford, 1998, p. 5) The treatment program should involve the following stated elements:

(1) Delivery of treatment in least restrictive setting;

(2) comprehensive treatment to address the problem identified in evaluation;

(3) treatment involves family in all aspects of treatment planning, discharge and recommendations for care.

(4) Primary therapeutic techniques are family therapy and cognitive behavioral therapy.

(5) Provision of general life skills, decision-making and coping skills education;

(6) emphasis on relapse prevention

(7) treatment is continuum of care and it is reported that a 12-month continuum of care "would enable practice and monitoring of new prosocial skills acquired in the primary treatment assignment. It is recommended that treatment services provided in the continuum of care utilize familial and community resources" (Rutherford, 1998, p. 8) .

Assessment of the effectiveness of the treatment program will be measured by:

(1) The frequency of substance use; the primary measure will be a reduction in the total number of days of use over the intervening period;

(2) The intensity of substance use; the primary measure will be a reduction in the number of times a day a drug is used;

(3) The number of substances an individual currently uses;

(4) The proportion of positive urinalyses collected over the intervening period

(5) The number of re-convictions for alcohol or drug related offenses in the intervening period

(6) Re-admission to a chemical dependency treatment program (detox, inpatient, or outpatient) over the intervening period;

(7) The number of emergency room visits; and (8) The number of inpatient medical hospitalizations. (Rutherford, 1998, 8-9)

Assessment will also be conducted by monitoring school performance improvements in the following areas;

(1) Improvement in grades; (Rutherford, 1998, p. 10)

(2) Decrease in truancy or dropout; (Rutherford, 1998, p. 10)

(3) Decrease in disciplinary actions; (Rutherford, 1998, p. 10)

(4) Improved family functioning over the intervening period as evidenced by: (a) fewer conflicts with family members; (b) greater parental satisfaction with adolescent's behavior; (c) decreased runaway episodes; (Rutherford, 1998, p. 10)

(5) Improved social functioning over the intervening period as evidenced by: (a) less time spent with substance-using and/or delinquent peers; (b) increased friendships with prosocial peers; (c) decreased feelings of alienation; (d) fewer incidences of unprotected sexual activity; (e) (Rutherford, 1998, p. 10)

(6) Improved psychological functioning over the intervening period as evidenced by: (a) fewer days of self reported mood disorders; (b) fewer days of aggressive or hostile acts towards family, peers or others; (c) fewer days of antisocial behaviors; (d) greater ability to concentrate on tasks; (e) fewer admissions for psychiatric treatment, either inpatient or outpatient; (f) decreased use of psychiatric medications; (Rutherford, 1998, p. 10)

(7) Improved vocational functioning (if applicable) over the intervening period as evidenced by: (a) fewer absences from work; (b) fewer days of late attendance or leaving early; (c) fewer disciplinary actions; and (d) more positive relationship with co-workers. (Rutherford, 1998, p. 10)

Summary and Conclusion

This study has examined the impact of genetics, culture, family and other factors in the life of the individual on the development of chemical dependency in the individual. All of these factors are found to play either positive or negative roles in the development of chemical dependency by the individual depending on the nature of these factors in the life of the individual. A treatment model, intervention and assessment methods have been identified for use in the case at focus.

Bibliography

Ashery, RS, Robertson, EB and Kumpfer, KL (1998) Drug Abuse Prevention Through Family Interventions. NIDA Research Monograph 177. U.S. Department of Health and Human Services. Retrieved from: http://www.dldocs.stir.ac.uk/documents/Monograph177.pdf

Barry, KL (1999) Brief Interventions and Brief Therapies for Substance Abuse Treatment Improvement Protocol (TIP) Series 34. Retrieved from: http://radar.boisestate.edu/pdfs/TIP34.pdf

Brower, KJ et al. (1989) Treatment Implications of Chemical Dependency Models: An Integrative Approach. Journal of Substance Abuse Treatment. Vol. 6. Retrieved from: http://deepblue.lib.umich.edu/bitstream/handle/2027.42/28142/0000594.pdf?sequence=1

Levin, JD, Culkin, J and Perrotto, RS (2001) Introduction to Chemical Dependency Counseling. Jason Aronson, 2 Jan 2001., Retrieved from: http://books.google.com/books?id=felzn3Ntd-cC&dq=chemical+dependency+and+genetics+and+cultural+environment&source=gbs_navlinks_s

Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) (nd) National Institute on Drug Abuse. Retrieved from: http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

Rutherford, M. (1998) Effectiveness Standards for the… [END OF PREVIEW]

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