Chap 11

SW 2300 Syllabus

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Social Work and Substance Abuse

Incidence

•Lifetime prevalence of alcohol abuse/dependence for those over 18 = 13.8%

•Lifetime prevalence of other substance abuse/dependence for those over 18 = 6.2.%

Order of prevalence

• Alcohol

• Cigarettes

• Marijuana

• Prescription type medications

• Cocaine

• Other illicit drugs such as inhalants

Variables associated with highest use

• Age 18-25

• More males

• Urban area

• Family History

Alcohol Abuse

• Classified as a depressant

• Alcohol abuse - problems associated with drinking

• Alcohol dependence - increased tolerance, withdrawal, inability to curtail use.

• Alcoholism - compulsive drinking

• 1:4 alcohol abuser

• 1:10 alcohol dependent

Types of Alcoholism

•Primary alcoholism - drinking is primary activity, living to drink

• Secondary alcoholism - drinking associated with mental illness, drinking to self-medicate

• Antisocial personality - especially in men

• Depression - especially in women, also history of victimization and violence

Health Effects of Alcoholism
• Fetal alcohol syndrome (FAS) - Primary cause of mental retardation in US

• Liver disease - cirrhosis

• Alcoholic dementia

• Traffic fatalities, home and work injuries

• High correlation with domestic violence

Issues in treatment:

• Detoxification and inpatient Care

• Residential treatment

• Intensive Day treatment

• 12 step programs (AA, NA)

• Outpatient treatment, groups, family,

• Cultural and Gender Issues

• Issue of sobriety vs. Controlled drinking

• Antabuse

• Dual diagnosis

Issues for social work

• Role of CAC

• Specialization vs. Generalization

• Knowledge of physiological process

• Counselor in recovery

• Medical model

• Legalization

• Medical professionals have the highest rate of substance abuse of all professions

The Alcohol Assessment

• Use of standardized screening tools

–MAST, Audit

• Always ask about drugs and alcohol

• Ask for specifics

–frequency

– amounts - give ridiculously high examples

– where, why, and with who do you drink

• Ask about family history

• Ask about traffic accidents, police records, legal action, lawsuits

• Ask how family feels about your drinking

• Ask about drinking related problems

• Ask about health