Treating drug problems

337 Pages·2005·3.219 MB·English

by  Arthur Blume

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Treating
Drug Problems
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Wiley Series on Treating Addiction
Series editors, Robert Holman Coombs and William A. Howatt
TREATINGDRUGPROBLEMS
Arthur W. Blume
TREATINGALCOHOLPROBLEMS
Frederick Rotgers
TREATINGGAMBLINGPROBLEMS
William G. McCown
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Treating Drug
Problems
Arthur W. Blume
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This book is printed on acid-free paper. ∞
Copyright © 2005 by John Wiley & Sons. All rights reserved.
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ISBN: 0-471-48483-0
Printed in the United States of America.
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To Karen, Amanda, and Rachel,
who each in her own way
has taught me valuable lessons
about love, life, compassion, and change.
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CONTENTS
Series Preface xv
Preface xvii
Acknowledgments xix
Chapter 1: Drug Problems: An Overview
Prevalence of Drug Abuse 2
What Exactly Is a Drug Problem? 5
The Three C’s 5
Compulsive Use 6
Loss of Control 8
Continued Use in Spite of Consequences 10
Myths Versus Facts Concerning Drug Problems 11
Patterns to Drug Problems 15
Transient Versus Chronic Problems 15
Dependence Versus Abuse 16
Psychological Versus Physical Dependence 18
Spontaneous Remission and Maturing Out 18
Clinical Versus Nonclinical Populations: Why Some
Do Not Mature Out 19
Progression 20
Drug Problems: A Biopsychosocial Model 21
Biological Risk Factors 22
Environmental Risk Factors 22
Behavioral Risk Factors 25
Cognitive Risk Factors 27
Cognitive Problems Related to Substance Abuse 29
Emotional Risk Factors 30
vii
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viii CONTENTS
Epidemiology of Certain At-Risk Populations 36
Influences of Age and Gender 37
Familial Considerations 39
Treatment Success/Failure 40
Recovery/Relapse Rates 42
The Unrecognized Treatment: Prevention Programs 42
What the Future Holds: What Is Next for Treatment? 44
Summing Up 45
Key Terms 46
Recommended Reading 46
Chapter 2: Recognizing a Drug Problem
Symptoms of a Drug Problem: What Family,
Friends, and Coworkers May Observe 51
Signs of a Drug Problem: What Professionals May Observe 55
When Collaterals Come for Help First 58
Recognizing the Existence of More Than One Problem 59
Co-occurring Mental Health Symptoms 60
Co-occurring Physical Health Symptoms 67
When Professionals May Be Impaired 68
How Attitudes Influence Drug Problems 69
Professional Collaboration 72
Professional Obligations to Intervene 74
Obligations Toward Other Professionals 76
Professional Referrals 78
Summing Up 87
Key Terms 87
Recommended Reading 88
Chapter 3: Utilizing Optimal
Professional Resources
Developing a Professional Network 90
Matching Clients to Therapists 94
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Contents ix
Referral Dos and Don’ts 95
Motivating Change 96
Motivational Strategies 98
Motivational Interviewing 103
The Transtheoretical Model 106
Overcoming Client Obstacles 110
Overcoming Therapist Obstacles 118
Preventing and Dealing With Crises 123
Aggression and Anger 123
Suicidal Behavior 124
Psychiatric Decomposition 129
Risk Management Strategies 132
Summing Up 133
Key Terms 133
Recommended Reading 134
Chapter 4: Developing an Effective
Treatment Plan
Intake Interview 137
Treatment Planning 139
Prioritizing Items on the Treatment Plan 143
The Importance of Assessment in Treatment 146
Assessing History and Diagnosis 146
Assessing Substance Use Patterns, Consequences, and Contexts 152
Assessing Client Potential for Behavior Change 155
Assessing Cognitive Function 158
Assessing Psychiatric Symptoms 160
Assessing Interpersonal Relations 162
Assessment as Intervention 162
Problems With Assessment Across Cultures 163
Involving Family and Friends in Treatment 166
Assessing Progress 170
Summing Up 175
Key Terms 176
Recommended Reading 176