Tag Archives: addiction

Stigma vs. Addiction – An Ongoing Problem

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Overcoming addiction is hard. There are the cravings, the feelings of shame, the intense impulses, uncontained emotions, the questioning, and the everlasting feelings of self-doubt. And then, there is the stigma.

Overcoming addiction is hard, and made harder by stigma. We must overcome our biases, assumptions, and fears to find helpful ways to treat it.

From 1999 to 2017, more than 399,000 people died from drug overdoses that involved prescription and illicit opioids, and yet, a stigma around opioid use remains.

In a review tracing the treatment of opioid use disorder in the United States dating back to the 1930s, with particular focus beginning with the widespread prescribed use of opioids to address symptoms of chronic pain in the 1990s, Dennis McCarty, Ph.D., a professor of public health in the OHSU-Portland State University School of Public Health; Kelsey Priest, M.P.H., an M.D./Ph.D. student in the OHSU School of Medicine and OHSU-PSU School of Public Health; and Todd Korthuis, M.D., M.P.H.; an associate professor of medicine (general internal medicine and geriatrics) in the OHSU School of Medicine, found that, “Opioid prevention and treatment efforts in the United States remain constrained and consequently stigmatized by a legacy of federal restrictions, an unwillingness to acknowledge idiopathic addiction, and a lack of science-based interventions for chronic pain” (McCarthy et al., 2017).

McCarthy and his team call for a system overhaul – one that embraces evidence-based therapies integrated into primary and specialty care. In short, one that acknowledges opioid addiction as a very real and pressing problem.

“The lessons learned in the first two decades of the new century have been hard learned and painful,” explains Mccarthy (McCarthy et al., 2017).

Lessons that many feel we cannot afford to repeat. Opioid addiction, whether we like it or not, is here. Our job is to try to understand it, to find helpful ways to treat it, to provide the resources those battling it need.

What we must overcome are our biases, our assumptions, and our fears about it. In the words of Martin Luther King Jr., “Darkness cannot drive out darkness: Only light can do that. Hate cannot drive out hate: Only love can do that.”

Related Online Continuing Education (CE) Courses:

Overcoming the Stigma of Mental Illness is a 2-hour online continuing education (CE/CEU) course that explores the stigmas around mental illness and provides effective strategies to overcome them. Course #21-24 | 2018 | 35 pages | 15 posttest questions

Nutrition and Addiction: Advanced Clinical Concepts is a 2-hour online continuing education (CE) course that examines addiction from a nutritional perspective. Drug addiction is an alarming problem in America, and one that is not receiving the treatment it needs. Compounding the problem is that addiction often leads to nutritional deficiencies, which predisposes the addict to a host of related health complications. Treatment recovery programs that also offer nutritional education have been found to significantly improve three-month sobriety success rates. Course #21-14 | 2017 | 30 pages | 15 posttest questions 

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for this program and its content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Georgia State Board of Occupational Therapy; the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors (#MHC-0135); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678); and is CE Broker compliant (all courses are reported within a few days of completion).

Enjoy 20% off all online continuing education (CE/CEU) courses @pdresources.org! Click here for details.

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Addiction and Cultural Competence

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Addiction and Cultural Competence – A Looming Concern

Addiction, it has been said, is a condition that crosses all socioeconomic, gender, age, and cultural lines. The more we learn about addiction, the more it seems that anyone, from anywhere, regardless of their background, can fall prey – especially when we consider the wide range of substances that people can become addicted to.

And no longer are addictions exclusive to illegal drugs or alcohol. In fact, prescription medication addiction – one of the fastest growing categories of addiction – is becoming increasingly common. As addictive pain medications like oxycodone are prescribed with greater frequency and wider range, the reality is that more people from are being exposed to potentially very addictive medications.

With greater exposure to addictive pain medication a broader range of people are being exposed – and that means people from a variety of cultures.

The implication, as one study led by researchers at the Center for Addiction and Mental Health (CAMH), and published in the Journal of Clinical Psychiatry evidences, is that people of Chinese and South Asian cultures may experience more severe mental illness at the time of hospital admission that other patients (Chiu et al., 2016).

Another implication is that Asian tobacco companies are now poised to enter the global market, which is likely to mean more people smoking – and addicted to tobacco – nationwide (Lee et al., 2017).

With a wider range of cultures exposed to addictive substances – and having them directly marketed to them – the concept of cultural competence becomes increasingly important for those clinicians who treat addiction.

Knowing what is expected and considered appropriate for each culture is a critical competent of establishing rapport with patients from different cultures. For example, one study found that handshaking – a Western staple greeting – is viewed more positively by Westerners than East Asians (Katsumi et al., 2017).

It is these social norms, argue sociologists, that govern our lives by giving us implicit and explicit guidance on what to think and believe, how to behave, and how to interact with others. When following the social folkways, mores, taboos, and laws of those from another culture, we gain a feeling of trust from them – which in the clinical setting, is indispensable.

Related Online Continuing Education (CE) Courses:

Improving Cultural Competence in Substance Abuse TreatmentImproving Cultural Competence in Substance Abuse Treatment is a 4-hour online continuing education (CE) course that proposes strategies to engage clients of diverse racial and ethnic groups in treatment. Culture is a primary force in the creation of a person’s identity. Counselors who are culturally competent are better able to understand and respect their clients’ identities and related cultural ways of life. This course proposes strategies to engage clients of diverse racial and ethnic groups (who can have very different life experiences, values, and traditions) in treatment. The major racial and ethnic groups in the United States covered in this course are African Americans, Asian Americans (including Native Hawaiians and other Pacific Islanders), Latinos, Native Americans (i.e., Alaska Natives and American Indians), and White Americans. In addition to providing epidemiological data on each group, the course discusses salient aspects of treatment for these racial/ethnic groups, drawing on clinical and research literature. While the primary focus of this course is on substance abuse treatment, the information and strategies given are equally relevant to all types of health and mental health treatment. Course #40-39 | 2015 | 75 pages (54 w/o references) | 30 posttest questions

Prescription Drug Abuse CE CoursePrescription Drug Abuse is a 3-hour online continuing education (CE) course that examines the misuse of prescription drugs (including opioids) in the United States. Misuse of prescription drugs means “taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria” and is a serious public health problem in the United States. When taken as prescribed, medication can be of great benefit to a patient, helping reduce pain, save lives, and improve one’s overall quality of life. However, when individuals misuse their prescribed medications or take medications not prescribed to them, the consequences can be disastrous. Illicit drug use, including the misuse of prescription medications, affects the health and well-being of millions of Americans. Among other deleterious effects, cardiovascular disease, stroke, cancer, infection with the human immunodeficiency virus (HIV), hepatitis, and lung disease can all be affected by drug use. The important thing to remember is that the medications are not inherently bad in and of themselves – it is how people use (and abuse) them that creates a problem. This course will discuss what drives people to abuse prescription drugs and how they obtain them; diagnostic criteria for substance use disorder; history and progression of prescription drug abuse, including types and classes of drugs used; and the cost of prescription drug abuse on addicts and non-addicts alike. The course will then review the sequence of treating individuals who have a prescription drug use disorder, including screening, assessment, diagnosis, treatment, and maintenance. Screening tools, assessment instruments, treatment programs, and evidence-based recommendations are included. Comorbidity between substance use disorder and mental disorders is also discussed. Course 31-00 | 2018 | 50 pages | 20 posttest questions

Cultural Awareness in Clinical PracticeCultural Awareness in Clinical Practice is a 3-hour online continuing education (CE/CEU) course that provides the foundation for achieving cultural competence and diversity in healthcare settings. Cultural competence, responding to diversity and inclusion, are important practices for healthcare professionals. This course will help you to gain an awareness of bias and provide strategies to adjust your clinical mindset and therapeutic approach to adapt to “the other” – people who differ in color, creed, sexual identification, socio-economic status, or other differences that make inclusion difficult. Inclusion is defined as “the state of being included” or “the act of including,” which is something all clinicians should strive for. This course is designed to provoke thought about culture, diversity, and inclusion. Even though research for evidence-based practice is somewhat limited in this area, the concept of cultural competency (however it is defined and measured) is a key skill for healthcare professionals to create an inclusive therapeutic environment. Course #31-07 | 2018 | 57 pages | 20 posttest questions

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Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: Psychologists, Counselors, Social Workers, Marriage & Family Therapist (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), School Psychologists, and Teachers

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Three Ways Nutrition Improves Addiction

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By Claire Dorotik-Nana @pdresources.org

nutrition and addictionFor clients recovering from addiction, so often the primary focus of treatment is on achieving and maintaining sobriety. And while effective therapy depends on sobriety, what is often missed are the client’s nutritional deficiencies – many that can dramatically increase the chances of picking up again.

Clients can, for example, have vitamin B, folate, and iron deficiencies, all of which will lead to general feelings of fatigue, lethargy, and poor cognitive functioning. On the other hand, depleted tryptophan (an amino acid often found in milk, turkey, and dairy products) stores can lead to depleted serotonin stores, and ultimately, states of mild depression.

More often than not, clients in recovery are not aware of their deficiencies and perhaps more importantly, the ways in which they affect how they feel. Yet following an improved nutritional program – one that addresses the common deficiencies of addiction – dramatically improves the way clients feel in many ways. Here are just three:

Increased Energy

Maintaining energy relies on regulating blood sugar, and maintaining adequate vitamin and mineral stores. However, both of these things depend on one thing only – nutrition. When clients follow a nutritional program designed to stabilize blood sugar, energy levels stabilize as well, and more often than not, clients experience more consistent and reliable feelings of energy. Further, when, through a healthy dietary intake of vitamins and minerals, deficiencies are restored, the body responds through better recovery, which lies at the heart of adequate energy levels. What this ultimately means for the client seeking sobriety, is less reliance on energy shortcuts – such as amphetamines or stimulants – to boost energy, and an improved sense of well-being.

Better Cognitive Functioning and Memory

Sobriety from any drug requires a wealth of frustration tolerance, emotional containment, and the ability to override strong impulses with and even stronger set of executive functions. In short, the brain in recovery is the brain on overdrive. Yet one hallmark of clients in recovery is poor executive functioning. Often not just repeated use of drugs and alcohol but an atrophied set of executive functions lead to a less than optimal ability to tolerate the stress of achieving sobriety. However, we also know that optimal brain functioning requires an optimal supply of nutrients. Through increasing intakes of Omega-3 Fatty acid, for example, memory and cognitive functioning can be improved significantly. Vitamins E, D, and several amino acids have also shown dramatic results on improved brain functioning. What this means for the client in recovery, is not only that they can rectify nutrient deficiencies, but that their cognitive functioning – and their chance of recovery – can be dramatically improved when they do.

Enhanced Mood

An unstable mood for the client in recovery is a major risk factor for relapse. Especially when clients are new in recovery and may not have the cognitive resources to overcome the strong impulses that accompany mood swings, the result can often be turning to their drug of choice. Moreover, an unstable mood often complicates the development of the very social support that fosters recovery. Yet a stable mood is dependent on a set of neurochemicals that may not be in abundant supply for the client in recovery. Therefore, replacing and fortifying neurochemicals becomes a primary step in stabilizing and improving mood. As neurochemicals are comprised of amino acids, this requires an adequate nutritional intake of them. Through improving their amino acid profile, clients can often quite markedly improve their mood, which then ripples outward improving their recovery program, and their adjustment to sober life.

Related Online Continuing Education (CE) Courses:

Nutrition and Addiction: Advanced Clinical Concepts is a 2-hour online continuing education (CE) course that examines addiction from a nutritional perspective. Drug addiction is an alarming problem in America, and one that is not receiving the treatment it needs. Compounding the problem is that addiction often leads to nutritional deficiencies, which predisposes the addict to a host of related health complications. Treatment recovery programs that also offer nutritional education have been found to significantly improve three-month sobriety success rates. The first section of this course will take a look at the etiology of addiction, related neurochemical factors and physiological components. The second section will focus on the nutrient deficiencies associated with addiction, along with the resultant effects on mood, cognition and behavior. The last section – the clinician’s toolbox – will give you, the clinician, targeted nutritional interventions and exercises that you can use with your clients to not just improve their recovery rates, but their overall mental health and wellbeing. Course #21-14 | 2017 | 30 pages | 15 posttest questions

Nutrition and Mental Health: Advanced Clinical Concepts is a 1-hour online continuing education (CE/CEU) course that examines how what we eat influences how we feel, both physically and mentally. While the role of adequate nutrition in maintaining mental health has been established for some time, just how clinicians go about providing the right nutritional information to the patient at the right time – to not just ensure good mental health, but actually optimize mood – has not been so clear. With myriad diets, weight loss supplements and programs, clients often find themselves reaching for the next best nutritional solution, all the while, unsure how they will feel, or even what to eat to feel better. On the other side of the equation, clinicians so often face not just a client’s emotional, situational, and relational concerns, but concerns that are clearly mired in how the client feels physically, and what impact his/her nutritional health may have on these concerns. For example, research into the role of blood sugar levels has demonstrated a clear crossover with client impulse control. Additionally, the gut microbiome, and its role in serotonin production and regulation has consistently made clear that without good gut health, mitigating anxiety and depression becomes close to impossible. So if good mental health begins with good nutritional health, where should clinicians start? What advice should they give to a depressed client? An anxious client? A client with impulse control problems? This course will answer these questions and more. Comprised of three sections, the course will begin with an overview of macronutrient intake and mental health, examining recent popular movements such as intermittent fasting, carb cycling and ketogenic diets, and their impact on mental health. In section two, we will look specifically at the role of blood sugar on mental health, and research that implicates blood sugar as both an emotional and behavioral regulator. Gut health, and specifically the gut microbiome, and its influence on mood and behavior will then be explored. Lastly, specific diagnoses and the way they are impacted by specific vitamins and minerals will be considered. Section three will deliver specific tools, you, the clinician, can use with your clients to assess, improve and maximize nutrition to optimize mental health. Course #11-06 | 2017 | 21 pages | 10 posttest questions

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These online courses provide instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion.

Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

 

3 Positive Activities to Do with Someone Recovering from Addiction

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By Adam Cook @ Addictionhub.org

Yoga Classes Have Several BenefitsPositive hobbies and coping mechanisms are key aspects of recovering from addiction. Many people have abused a substance in order to escape reality or relieve the symptoms of a mental illness. This usually means the person does not know how to cope with reality or mental illness in a positive way. As a loved one, you may not know how to help someone struggling with addiction. Fortunately, it is easier than you think. In fact, there are a few positive activities to do with a loved one on the road to addiction recovery, and we share our favorites below.

Meditation Is a Useful Tool

Setting up a regular time to attend meditation classes or sessions can be a positive way to spend time with your recovering loved one. Meditation has been shown to help with a wide variety of problems including addiction, stress, depression, and anxiety. Learning to quiet the mind and spend some of his day in peace is possibly one of the best things a recovering addict can do. Try suggesting a meditation workshop as a fun activity for you to do together. For particularly resistant people, you might want to phrase it as something you want to do for your well-being.

Yoga Classes Have Several Benefits

Traditional yoga combines exercise with meditative practice, providing both inner peace as well as the benefits of exercise. Exercise is one of the best ways to combat an addiction, as it improves physical health, reduces stress, and releases mood-lifting endorphins. Yoga is ideal because it can be practiced regardless of skill level or fitness level and will create a positive headspace for you and your loved one. If classes go beyond your comfort levels, there are also instructional videos available free of charge online.

Learning a Craft is a Fun, Stress-Busting Activity

Keeping stress levels low is an important part of recovering from addiction. Interestingly, one of the best ways to reduce stress at home is to take up a craft. Working with the hands to create something enjoyable can be fun for both you and your loved one as you reduce stress and learn a new skill. You might even consider a crafting class such as learning to crochet, scrapbook, whittle, or even design an indoor succulent garden.

Though the hobby choice does not necessarily matter, an activity such as knitting or sewing clothes can have the added effect of helping your loved one feel useful. People who struggle with addiction and depression may feel as though their daily lives are meaningless, which opens the door to relapse. Making and donating clothes or toys to those in need can be a good way to combat that feeling.

Watching a loved one struggle with an addiction is extremely trying. You may feel a little uncomfortable getting involved, or you may not know how to respond to the situation. Though talking openly is important for someone in recovery, you do not necessarily have to take on the therapist role to help your loved one get well. Instead, plan on attending some classes with your loved one. Learn how to meditate effectively or make weekly yoga a consistent part of your routine. You also can sit down together and simply learn how to make something fun. It’s a matter of giving your loved one some time to take his mind off his addiction and do something positive that helps him feel better.

Related Online Continuing Education (CE) Course:

The Mindfulness Workbook for Addiction is a 5-hour home study course based on the book “The Mindfulness Workbook for Addiction: A Guide to Coping with the Grief, Stress and Anger that Trigger Addictive Behaviors” (2012, 232 pages). This workbook presents a comprehensive approach to working with clients in recovery from addictive behaviors and is unique in that it addresses the underlying loss that clients have experienced that may be fueling addictive behaviors. Counseling skills from the field of mindfulness therapy, cognitive-behavioral therapy, acceptance and commitment therapy, and dialectical behavioral therapy are outlined in a clear and easy-to-implement style. Healthy strategies for coping with grief, depression, anxiety, and anger are provided along with ways to improve interpersonal relationships. Course #50-14 | 30 posttest questions

Professional Development Resources is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

Technology-Crazy: Are We Setting our Kids up for Future Addiction?

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By KENS 5’s Deborah Knapp

Technology-crazy: Are we setting our kids up for future addiction?Is the internet making us crazy?

New research finds 61 percent of those surveyed feel addicted to the internet, and 68 percent say they suffer from internet “disconnect anxiety.”

Another study found people check their smartphones 34 times a day. In fact, it had become a compulsion. Whether it’s our smartphones, Facebook, Twitter or video games, every age group is at risk of being unknowingly obsessed with technology.

One expert has said the computer is like electronic cocaine, fueling cycles of mania followed by depression. Mental health and dependency specialist, Dr. Gregory Jantz, suggests a tech-detox day.

Watch the full story: http://www.kens5.com/news/Are-we-setting-our-kids-up-for-future-addiction–162132545.html

Related Online CEU Course:

Ethics and Social MediaEthics and Social Media is a 2-hour online CEU course that offers psychotherapists the opportunity to examine their practices in regard to the use of social networking services in their professional relationships and communications. Is it useful or appropriate (or ethical or therapeutic) for a therapist and a client to share the kinds of information that are routinely posted on Social Networking Services (SNS) like Facebook, Twitter, and others? How are psychotherapists to handle “Friending” requests from clients? What are the threats to confidentiality and therapeutic boundaries that are posed by the use of social media sites, texts, or tweets in therapist-client communication? The purpose of this course is to offer psychotherapists the opportunity to examine their practices in regard to the use of social networking services in their professional relationships and communications. Included are ethics topics such as privacy and confidentiality, boundaries and multiple relationships, competence, the phenomenon of friending, informed consent, and record keeping. A final section offers recommendations and resources for the ethical use of social networking and the development of a practice social media policy.

Professional Development Resources is approved as a provider of continuing education by the Association of Social Work Boards (ASWB #1046); the National Board of Certified Counselors (NBCC #5590); the American Psychological Association (APA); the National Association of Alcoholism & Drug Abuse Counselors (NAADAC #000279); the Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346); the California Board of Behavioral Sciences (#PCE1625); the Texas Board of Examiners of Marriage & Family Therapists (#114); the South Carolina Board of Professional Counselors and Marriage & Family Therapists (#193); and the Ohio Counselor, Social Worker and Marriage & Family Therapist Board (#RCST100501).

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DSM-5: The End of One-Size-Fits-All Addiction Treatment?

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By Mark Willenbring

DSM-5: The End of One-Size-Fits-All Addiction Treatment?When the dust of debate settles, the new revision’s benefits should be clear: good science, better diagnoses, more individualized care.

Sometime this month, the DSM-5 will replace the DSM-IV as the coin of the realm for diagnosis of mental illnesses, including substance use disorders. Despite the unprecedented criticism that has accompanied the process, the final product’s changes are based on very solid epidemiological research, and they are likely to reduce ambiguity and confusion. But there may be some surprise, too, as received wisdom about the diagnosis and treatment of addiction is turned on its head. Let’s hope that this development will result in a more rational and nuanced approach to addiction.

When the DSM-IV was developed, it appeared that abuse and dependence were two distinct disorders. Substance abuse was defined according to four criteria; dependence, according to seven criteria. In practice, “abuse” was often used to denote a milder form of Substance Use Disorder (SUD); “dependence,” a more severe SUD.

In the case of opioids, “dependence” was confusing because almost anyone on opioid-based painkillers for any length of time develops physiological dependence (they will have withdrawal if they stop suddenly), whereas in the DSM-IV, “dependence” meant “addiction” (pathological, compulsive, harmful use). So pain patients prescribed opioids were mislabeled as opioid “dependent” even though they took their medication as prescribed.

Since then, a considerable body of research has shown that there are not two distinct types of substance misuse, but only one. More important, most DSM-IV “abuse” symptoms develop only in people with severe addiction, while “dependence” symptoms are among the earliest to develop. In the DSM-5, “abuse” and “dependence” are gone. In their place is the single “Substance Use Disorder.”

With alcohol, for example, the earliest and most common problems are “internal” problems, such as going over limits, persistent desire to quit or cut down, and use despite hangover or nausea. The only “abuse” criterion that develops early is drinking and driving, but without a DUI. In the largest study of its kind, the NIAAA Epidemiological Study of Alcohol and Related Conditions (NESARC), 90 percent of people who met criteria for DSM-IV alcohol abuse—but not dependence—did so because of admitting drinking and driving. All other abuse criteria only occurred in people with the most severe and chronic addiction, and then late in the game.

In fact, legal problems occur so infrequently that this criterion was dropped from theDSM-5. This may come as a surprise to people working in the treatment industry because legal problems are the most common reason people seek treatment in rehab. But only about 12 percent of people with DSM-IV alcohol dependence ever seek specialty treatment, which suggests that the rest—who are not in treatment—have less severe disorders. People in rehab or AA are to alcohol use disorder what asthmatics on a ventilator in the ICU are to people with asthma: the most severe, treatment-refractory disorders as well as the most co-morbid psychiatric and medical problems. We’ve made a large error by assuming that everyone in the community who meets the criteria for a substance disorder has exactly the same disease as people in rehab or AA.

Read more @ http://www.psmag.com/health/dsm-5-the-end-of-one-size-fits-all-treatment-57193/

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Prescription Drug Abuse – New Online CE Course

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Prescription Drug Abuse

By: Stephanie Sarkis, PhD, NCC, LMHC

CE Credit: 3 Hours

Target Audience: Psychology | Counseling | Social Work | Occupational Therapy | Marriage & Family Therapy

Learning Level: Intermediate

Course Type : Online

Prescription Drug AbuseCourse Abstract: Prescription drug abuse is on the rise. Pharmaceuticals like OxyContin®, Adderall®, and Xanax® are some of the most commonly abused prescription drugs. For some prescription drug addicts, medication was originally taken as prescribed – until they started developing a tolerance for it. For others, members of their peer group began to abuse prescription drugs because they are easily accessible and relatively inexpensive on the street. Prescription drug abuse also affects those who don’t use – through increased costs and the inconveniences of increased security at pharmacies. Treatment is comprised of a series of steps, including detoxification, inpatient/outpatient treatment, and maintenance. In some cases, patients must be closely monitored because of the potential for withdrawal effects. Once treatment is completed, there are various options for maintaining sobriety. Laws are being tightened, and some medications have become difficult to find due to the increased rate of prescription drug abuse. Course #30-61 | 2012 | 30 pages | 20 posttest questions
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Should Addicts be Sterilized?

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Project Prevention has long paid poor, addicted women not to procreate. Now the far right is helping it go global.

BY , THE FIX

Should addicts be sterilized?

A volunteer outside a Project Prevention van

“Don’t let a pregnancy ruin your drug habit,” the slogan on the fliers reads. Another says, “She has her daddy’s eyes…and her mommy’s heroin addiction.” Then: “Get birth control, get ca$h.” These are posters that show up nationwide in homeless shelters and methadone clinics, in AA and NA meeting rooms and near needle exchange programs, distributed by volunteers for Project Prevention. Formerly called Children Requiring a Caring Kommunity (CRACK), the controversial nonprofit pays drug addicts $300 to either undergo sterilization or use a form of long-term, “no responsibility needed” birth control.

“What makes a woman’s right to procreate more important than the right of a child to have a normal life?” Project Prevention founder Barbara Harris told Time magazine in 2010. The question is entirely rhetorical: her self-professed mission in life is to zero out the number of births to parents who abuse illegal drugs, particularly crack cocaine. “Even if these babies are fortunate enough not to have mental or physical disabilities, they’re placed in the foster-care system and moved from home to home,” she says.

Critics of many stripes have piled on. They argue that Harris’ campaign deprives women who are addicted, poor and vulnerable of reproductive choice even as it feeds their drug habit.

Some opponents say that, since the financial incentive is tantamount to giving addicts money to buy drugs, Project Prevention should be illegal.

Others say that if addicted women are viewed as not responsible enough to have a baby, then they should also be viewed as not responsible enough to give informed consent to having a serious medical procedure in exchange for drug money.

Still others say that Harris is stuck in the past by targeting the wrong drugs: these days, more babies are born dependent on Oxy and other legal opiate painkillers than cocaine or heroin, according to a report published just this week in JAMA.

And many opponents say that the payment is a bribe, and some have even called Project Prevention a revival of the eugenics movement.

Harris takes none of these criticisms seriously. The California foster mother, age 59, started the program in 1997, following her failed effort to get the Prenatal Neglect Act through the California state legislature. The bill would have made it a crime for a pregnant woman to use illegal drugs. (Such laws exist in many states: last week’s Sunday New York Times Magazine profiled an Alabama woman named Amanda Kimbrough who is serving 10 years in prison for doing crystal meth while pregnant and giving birth after only 25 weeks to a very underweight baby who died.) Shifting tactics, the homegrown activist then began her campaign for a less punitive, if more final, solution to the “problem” of drug-addicted mothers bringing children into the world: pay them not to procreate.

Read more: http://www.salon.com/2012/05/02/should_addicts_be_sterilized_salpart/singleton/

How Mindfulness Aids In Addiction Recovery

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By David Sack, MD

For many of us, daily life is about “going through the motions.” How often do you drive from point A to point B without remembering how you got there?

Are you able to focus on one activity at a time or are you a multi-tasker who juggles five things at once?

Modern life is not always conducive to staying in the present moment, but as we are learning in the addiction field, the practice of mindfulness can bring greater joy into daily life and also help recovering addicts guard against relapse.

Increasingly, the field is embracing Eastern practices, including mindfulness meditation, as an adjunct to traditional addiction treatments.

Mindfulness vs. Addiction

Mindfulness, which has its roots in Buddhism, involves a purposeful and nonjudgmental focus on one’s feelings, experiences, and internal and external processes in the present moment. Rather than escape from painful feelings, mindfulness meditation encourages addicts to sit quietly with themselves and pay close attention to their thoughts and feelings without taking action to judge or “fix” them.

It is not about apathy or suppression of feelings, but rather the freedom to experience the full range of feelings and strategically choose how to respond.

Like yoga, tai chi and related practices, mindfulness is a portable skill that can become a regular part of the recovering addict’s life, both during and after treatment. It takes only a few minutes and can be done by anyone anywhere, and its effects are long-lasting.

A Life Skill with Wide Applicability

Mindfulness-based therapy has been used for a variety of ailments, including anxiety, depression, chronic pain, physical illnesses and addiction, but its usefulness extends even further. Mindfulness can be applied to every area of life, including the most mundane daily tasks like house cleaning, taking a walk or eating a meal. Even decades into recovery, mindfulness is a way to stay fully invested in life.

Source: http://blogs.psychcentral.com/addiction-recovery/2012/04/how-mindfulness-aids-in-addiction-recovery/

Related Online Continuing Education Course:

Mindfulness: The Healing Power of Compassionate Presence

Mindfulness: The Healing Power of Compassionate Presence This course will give you the mindfulness skills necessary to work directly, effectively and courageously, with your own and your client’s life struggles. Compassion towards others starts with compassion towards self. Practicing mindfulness cultivates our ability to pay intentional attention to our experience from moment to moment. Mindfulness teaches us to become patiently and spaciously aware of what is going on in our mind and body without judgment, reaction, and distraction, thus inviting into the clinical process, the inner strengths and resources that help achieve healing results not otherwise possible. Bringing the power of mindful presence to your clinical practice produces considerable clinical impact in the treatment of anxiety, depression, PTSD, chronic pain, high blood pressure, fibromyalgia, colitis/IBS, and migraines/tension headaches. The emphasis of this course is largely experiential and will offer you the benefit of having a direct experience of the mindfulness experience in a safe and supportive fashion. You will utilize the power of “taking the client there” as an effective technique of introducing the mindful experience in your practice setting. As you will learn, the mindfulness practice has to be experienced rather than talked about. This course will provide you with an excellent understanding of exactly what mindfulness is, why it works, and how to use it. You will also develop the tools that help you introduce mindful experiences in your practice, and how to deal with possible client resistance.

Course #60-75 | 2008 | 73 pages | 27 posttest questions

Customer Reviews:

“This was the best online ceu I have ever taken! Wow! Great stuff. Thank goodness I printed it out. I will start using it tomorrow. Thank you.” – M.C. (MFT)

“Great course, excellent reference materials and loads of practical exercises!” – L.O. (Social Worker)

“Nice integration of case examples with the course material.” – A.B. (Psychologist)

“One of the BEST courses I have EVER taken!!! GREAT Learning!!” – L.M. (Psychologist)

Learn More: http://www.pdresources.org/CourseDetail.aspx?Category=AllCourses&PageNumber=1&Profession=Other&Sort=CourseID&Text=60-75&courseid=972