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Module 3: Prevention, Screening, Referral, & Treatment
 

Module 3: Prevention, Screening, Referral, & Treatment

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Prevention, Screening, Referral, & Treatment

Prevention, Screening, Referral, & Treatment

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    Module 3: Prevention, Screening, Referral, & Treatment Module 3: Prevention, Screening, Referral, & Treatment Presentation Transcript

    • Funding for this module was provided by a Science Education Drug AbusePartnership Award (SEDAPA) from the National Institute on Drug Abuse, acomponent of the National Institutes of Health, Department of Health andHuman Services # 1 R25 DA 020472-01A1Fullscreen
    • Module3 Prevention,Screening,Referral,& Treatment# 1 R25 DA 020472-01A1
    • Apply Module 1 & 2 concepts to better understand:• the principles of effective-- Prevention-- Screening, Brief Intervention, & Referral to Treatment (SBIRT)-- Treatment-- Recovery• addiction as a chronic medical illnessthat requires management similar toother chronic diseases (e.g., asthma,diabetes, & hypertension)Module 3 Learning Objectives# 1 R25 DA 020472-01A1
    • ExploringPrevention# 1 R25 DA 020472-01A1
    • # 1 R25 DA 020472-01A1
    • Your Brain on Drugs# 1 R25 DA 020472-01A1
    • Your Brain on Heroin# 1 R25 DA 020472-01A1
    • What Have WeLearned# 1 R25 DA 020472-01A1
    • Inaccuratemedical orscientificinformationPledging  not  to  use  Most  scare  tac*cs  Most  scare  tac*cs  These things don’t work …# 1 R25 DA 020472-01A1
    • # 1 R25 DA 020472-01A1
    • Above the Influence CampaignFitting In# 1 R25 DA 020472-01A1
    • Dogs Know AllMost of Us# 1 R25 DA 020472-01A1
    • Real WorldMost of Us# 1 R25 DA 020472-01A1
    • Evidence - basedPreventionPrograms# 1 R25 DA 020472-01A1
    • ... need to be comprehensive, involvingall segments of the community(school, family, social services, law enforcement, business,policy makers, faith community)(SAMHSA, 2009)# 1 R25 DA 020472-01A1
    • Targeted to universal, selected, andindicated populations.(SAMHSA, 2009)# 1 R25 DA 020472-01A1
    • ReduceriskfactorsIncreaseprotectivefactors(SAMHSA, 2009)# 1 R25 DA 020472-01A1
    • • information dissemination;• education;• alternative activities;• problem identification & referral;• community-based processes;• environmental approachesMultiple, evidence-based strategies(SAMHSA, 2009)# 1 R25 DA 020472-01A1
    • Exploring Screening& Brief Interventions# 1 R25 DA 020472-01A1
    • What isScreening# 1 R25 DA 020472-01A1
    • Screening:Brief procedure to identifyindividuals with possible AODproblems or who are at risk fordeveloping SUDs# 1 R25 DA 020472-01A1
    • (Babor & Higgins-Biddle, 2001# 1 R25 DA 020472-01A1
    • ScreeningInstruments
    • Screening Instruments• Alcohol Use Disorders Identification Test (AUDIT)• http://www.alcoholscreening.org/• 10 items used in primary healthcare settings• developed by the World Health Organization• 0-4 scoring (0=never, 4=daily or almost daily)
    • # 1 R25 DA 020472-01A1
    • Have you ever felt the need to Cut down on your drinking?CAGEHave you ever had a drink first thing in the morning to steady your nerves and get rid of a hangover (Eye-opener)?Have you ever felt bad or Guilty about your drinking?Have you ever felt Annoyed by someone criticizing your drinking?# 1 R25 DA 020472-01A1
    • If you answered “YES”to two or more of thesequestions you are at riskof problem drinking oralcoholism.# 1 R25 DA 020472-01A1
    • What is BriefIntervention# 1 R25 DA 020472-01A1
    • Brief Interventions: Techniques to changethe behavior of people who use AOD at riskylevels before the development of SUDs.• Normally conducted in general healthcare settings, schools, or social service agencies• Light or Moderate Users: education and guidelines for low-risk use and problems that may occur from increased use• At Risk Users: interventions to encourage moderation or abstinence# 1 R25 DA 020472-01A1
    • Brief InterventionsSteps1. Introduce issue in context of health2. Screen, evaluate, assess stage of change3. Provide feedback4. Set goals5. Summarize and reach closure# 1 R25 DA 020472-01A1
    • Screening & Brief Intervention can bedone as part of ROUTINE VISITS(Babor & Higgins-Biddle, 2001)# 1 R25 DA 020472-01A1
    • Exploring DrugTreatment# 1 R25 DA 020472-01A1
    • Addiction as a Chronic Medical Illness40-60% of adults and as many as 80% of adolescentsrelapse within one year post-treatment# 1 R25 DA 020472-01A1
    • Relapse Rates After Treatment Are Similarto Other Chronic Medical ConditionsAlmost 50% of patients remain continuouslyabstinent 1-year after treatment, with 15-30% notreturning to “dependent” levels of use.(O’Brien & McLellan, 1996)# 1 R25 DA 020472-01A1
    • Factors associatedwith addiction relapseare similar to otherchronic illnesses:• Lack of adherence to lifestyle & behavior changes needed to support health• Low socioeconomic status• Low family support• Psychiatric co-morbidity(O’Brien & McLellan, 1996)# 1 R25 DA 020472-01A1
    • What are thePrinciples ofEffective Treatment# 1 R25 DA 020472-01A1
    • NIDA Publications# 1 R25 DA 020472-01A1
    • No single treatmentis appropriate forall individuals# 1 R25 DA 020472-01A1
    • Behavioraltherapy isa criticalcomponentof effectiveaddictiontreatment# 1 R25 DA 020472-01A1
    • Effectivetreatmentattends tomultiple needsof individuals…not just theirdrug use.# 1 R25 DA 020472-01A1
    • Addicted ordrug-abusingindividuals withcoexisting mentaldisorders shouldreceive integratedtreatment# 1 R25 DA 020472-01A1
    • Remaining intreatment foran adequateperiod of timeis critical fortreatmenteffectiveness# 1 R25 DA 020472-01A1
    • Treatment does not need to bevoluntary to be effective# 1 R25 DA 020472-01A1
    • Is RecoveryPossible# 1 R25 DA 020472-01A1
    • Behavioral Change is a process that unfolds overtime through a sequence of stages# 1 R25 DA 020472-01A1
    • Hesitancy aboutis human Nature(Hettema, Steele, & Miller, 2005)# 1 R25 DA 020472-01A1
    • Can these changes be reversed?AddictionTreatmentRecovery# 1 R25 DA 020472-01A1
    • Recovery of DopamineReceptors with AbstinenceDopamine receptors (yellow)in normal non-addicted brainDopamine receptors (yellow)in cocaine abuser after10 days abstinenceDopamine receptors (yellow) incocaine abuser after100 days abstinence# 1 R25 DA 020472-01A1
    • Dopamine Receptor Recoveryin the Adolescent Brain with AbstinenceBefore treatment, brain activationwas greater in response tomarijuana cues vs. food cues in thereward system areas of the brain.After 16 weeks of treatment, brainactivation was greater in response tomarijuana cues vs. food cues in thecognitive control areas of the brain.(Riggs et al., 2007)Pre-Treatment Post-Treatment# 1 R25 DA 020472-01A1
    • Recovery is along-termprocess & canrequire going intotreatmentmultiple times# 1 R25 DA 020472-01A1
    • Key Take Home Messages# 1 R25 DA 020472-01A1
    • • Addiction is a chronic illness similar to other chronic diseases such as hypertension, asthma, & diabetes• Treatment for addiction is as effective as treatment for many other chronic medical conditions• Addiction treatment compliance & relapse rates also are similar to other chronic illnesses, often requiring multiple treatment episodes & long-term clinical management• Effective prevention incorporates multiple strategies & engages all segments of the community to reduce risk factors & increase protective factors# 1 R25 DA 020472-01A1
    • • Screening & brief interventions can be effective in modifying the behavior of moderate & at-risk alcohol & drug users• Long-term abstinence & recovery from addiction is possible with treatment; lifestyle changes; family & peer support; & continuing care• Research shows that with treatment & sustained abstinence, the brain can recover from the neurobiological damage caused by substance abuse• Treatment for addiction can significantly reduce the public health impact & costs of addiction# 1 R25 DA 020472-01A1
    • “…the way clients are spoken to about changingaddictive behavior affects their willingness to talkfreely about why and how they might change.”(Rollnick, 2001)# 1 R25 DA 020472-01A1
    • AVOIDusingmoral orjudgmentalstatements# 1 R25 DA 020472-01A1
    • Be Supportive & Non-Judgmental# 1 R25 DA 020472-01A1
    • Members of the allied healthcarecommunity have a professional &ethical responsibility, perhaps even ato develop competencies for thedetection & early intervention of SUDsMandate# 1 R25 DA 020472-01A1
    • ProfessionalCase Study# 1 R25 DA 020472-01A1
    • What Do You Believe About Addiction?1. Why do people become addicted?2. Can addiction be prevented? (Why or why not)3. If treatment works, why do so many people go into treatment multiple times?4. People with addictions are ? (List three characteristics of people with an addiction.)# 1 R25 DA 020472-01A1
    • ...impacts us all.# 1 R25 DA 020472-01A1