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ADDICTION. Jean Sassatelli RN, MS Senior Director Behavioral Health Services Catholic Charities of Omaha. WHAT IS ADDICTION.
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ADDICTION Jean Sassatelli RN, MS Senior Director Behavioral Health Services Catholic Charities of Omaha
WHAT IS ADDICTION • When the use of alcohol and/or mood altering drugs causes problems in the individual’s family, social, work, school, legal, physical and/or emotional aspects of their life.
WHAT IS ADDICTION • Addiction is a pathological love relationship with a mood altering chemical, (or activity – i.e. gambling, sex, food). (McAuliffes’ Essentials of Chemical Dependency)
BEHAVIORAL SIGNS ADDICTION • Change in attitude/personality for no identifiable reason. • Change in friends, new hangouts • Decreased performance at school, work and/or home. • Change in activities or hobbies • Change in habits at home • Loss of interest in family and family activities
BEHAVIORAL SIGNSADDICTION • Forgetfulness and difficulty paying attention • Lack of motivation, energy, self-esteem… ‘I don’t care’ attitude • Sudden over sensitivity, temper tantrums • Moodiness, irritability, or nervousness • Silliness or giddiness • Paranoia
BEHAVIORAL SIGNSADDICTION • Excessive need for privacy • Secretive or suspicious behavior • Chronic dishonesty • Unexplained need for money • Change in personal grooming • Sudden change in wardrobe, hairstyle, or jewelry
ADOLESCENT ADDICTIONUsage by Youth in Grades 9 -12 • Alcohol: 82% • Marijuana: 31% • Inhalants: 13% • Meth.: 8% • Cocaine: 7% 1999 Youth Risk Behavior Survey of Nebraska
CURRENT TRENDS ADOLESCENT ADDICTION • 26% of youth have their first drink of alcohol before the age of 13. • 28% of all fatal alcohol related motor vehicle accidents involve youth between 15 –20. • Alcohol is a major factor in 50% of all motor vehicle accidents, homicides, and suicides among youth.
ADOLESCENT ADDICTIONJuvenile Justice Link • 83 % of youth involved with the Juvenile Justice System have alcohol and drug use problems. • Inhalant Use is more common in this group…
NEED Likely to Demand Services Likely to Demand Specialty Services ADULT: Mental Health (Unduplicated) % Number % Number Diagnosed Mental Disorders 83,394 20% 16,679 37% 6,171 Serious Mental Illness 12,041 40% 4,816 50% 2,408 Diagnosed SPMI 9,009 70% 6,306 76% 4,793 Disabled by SPMI 3,032 90% 2,729 93% 2,538 TOTAL ADULTS - MH 107,476 28% 30,093 53.9% 15,910 ADULT Substance Abuse 32,555 20% 6,511 20% 1,302 TOTAL Behavioral Health – Adults 140,030 26.1% 36,604 47.7% 17,212 Substance Abuse Prevalence Data Based on Nebraska 1999 Census
ADULTS Co-Occurring MH & SA Estimated Need Co-Occurrence by Level of Mental Disorder % Likely to Demand Specialty Services Diagnosable Mental Disorder 83,394 11.6% 9,674 37% 3,579 Serious Mental Illness 12,041 19.3% 2,324 50% 1,162 SPMI 9,009 25.9% 2,333 76% 1,773 Disable by SPMI 3,032 33.3% 1,010 93% 939 Total Co-Occurring MH/SA 107,476 14.3% 15,341 52.9% 7,455 Estimated Region VI – Adults with Co-Occurring Disorders (38.8%) 41,701 5,952 2,893 Substance Abuse Prevalence Data Based on Nebraska 1999 Census
ADDICTIONCo-Occurring Disorders • Substance Abuse combined with Mental Illness, occurs in 70% of those addicted. • The presence of co-occurring disorders reduces the responsiveness to treatment. • There is serious risk of missing a co-occurring disorder because the symptoms are ‘masked’ by the substance use.
Homeless • National: 2,000,000 • Nebraska: 9,280
FAMILY MATTERSThe Effects of Addiction on the Family U.S. Dept. of Health & Human Services: • 10 million untreated persons in 2000 • 3 million received treatment in 2000
FAMILY MATTERSThe Effects of Addiction on the Family • Addiction is one of the families most guarded secrets. • Co-Dependency: Condition characterized by preoccupation and extreme dependency (emotional, social & physical) on a person or object. This becomes pathological.
FAMILY MATTERSThe Effects of Addiction on the Family • FAMILY ROLES: • Dependent • Enabler • Hero • Scapegoat • Lost Child • Mascot
FAMILY MATTERSThe Effects of Addiction on the Family • FAMILY SYSTEMS: • All members assume specific roles & relate to each other in characteristic ways. • The roles that family members adopt & how they relate to each other operate according to “rules”. Roles and patterns constitute equilibrium. • Any shifts in family equilibrium will cause resistance & system will seek a return to equilibrium. • No matter how sick/abnormal it may appear, the established equilibrium represents the family’s attempt to minimize threat of pain & disruption
FAMILY MATTERSThe Effects of Addiction on the Family THE FAMILY SECRET ? Family requires intervention… all have affected, all need treatment!
ADDICTIONGRIEF REACTION • Grief is at the core of the recovery process. Much like the death or ending of a long-term relationship, the addicted individual has a committed, love relationship with their chemical, person, thing, and the discontinuation of this relationship causes a significant and very real experience of loss.
ADDICTION5 STAGES OF GRIEF • Denial & Isolation • Anger • Bargaining • Depression • Acceptance
ADDICTIONTREATMENT • Philosophical Approach: • Holistic • Family Systems Oriented • Developmentally Based • Treatment Components: • Comprehensive Assessment • Plan of treatment based on the development strengths and needs of the adolescent, as well as the family strengths and needs.
Crisis Services: • Medically Monitored Detoxification • Civil /Emergency Protective Custody • Prevention & Education Services: • Community Support • Post Primary Group • Correctional Services • Alumni Association • Treatment Services: • Outpatient Treatment • Intensive Outpatient • Short Term Residential • Transitional Services: • Intermediate Residential • Halfway House