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Substance Abuse

Substance Abuse. Dr. Elena Klaw Psyc . 190. Goals for Today. Assessing alcohol use: CAGE Transition Workbook for Combat Veterans (Naval Combat Research Center) Facts Signs to look out for: stress & addiction What to do Practice Motivational Interviewing (MI).

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Substance Abuse

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  1. Substance Abuse Dr. Elena Klaw Psyc. 190

  2. Goals for Today • Assessing alcohol use: CAGE • Transition Workbook for Combat Veterans (Naval Combat Research Center) • Facts • Signs to look out for: stress & addiction • What to do • Practice Motivational Interviewing (MI)

  3. Assessment: CAGE (Ewing, 1984)http://counsellingresource.com/ 1. Have you ever felt you should cut down on your drinking? 2. Have people annoyed you by criticising your drinking? 3. Have you ever felt bad or guilty about your drinking? 4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?

  4. General Definitions • Problem drinking: alcohol use that causes functional impairment, and/or interferes with your responsibilities, your life & relationships – it causes problems! • Thought of as a bad habit • Addiction: characterized by increasing tolerance and withdrawal symptoms, long term heavy alcohol use will cause the shakes (DT), memory loss, and liver damage • Thought of a disease (AA: alcoholism) or disorder (DSM: dependence)

  5. Public Health GuidelinesU.S. Dept. Health & Human ServiceNIAAA Women should keep regular drinking to 1 drink or fewer (12 oz. beer, 5 oz. wine, 1.5 oz. 80 proof alcohol); for men 2 or fewer drinks Women should not exceed 3 drinks on any day, or a total of 7 per week Men should limit to 4 drinks per day and 14 per week Do not drink if you are responsible for work, care or safety of others. DOD standard is never drive after any drinking.

  6. Discuss What are Signs of Stress?

  7. Discuss What are signs of addiction?

  8. Signs of Stress Diffuse pain: muscle aches, headaches Upset stomach Fatigue Change in eating Drastic change in weight Irritability/short temper Sleeping all the time or insomnia Lack of follow through, poor work quality Anhedonia

  9. Signs of Possible Addiction Frequent lateness or absence Excuse Blaming others Mood swings Changes in relationships Falling asleep at work Avoiding others Careless risk taking Financial problems Deteriorating self care Evidence of use at work

  10. What You Can Do • Confront gently “I have noticed… Is everything OK?” • Do not judge or diagnose, state what you have noticed • Refer to relevant medical and counseling resources; include mutual help and recovery groups: • AA: www.alcoholics-anonymous.org, • MM: www. Moderation.org • SMART: http://www.smartrec-sv.org/

  11. Partner Activity: Motivational Interviewing (MI) • Think of a habit you each want to change. • Ask your partner: • What are the risks of changing? • What are the benefits of changing? • Restate this for your partner. Then ask: • What is your goal? • What are your triggers (antecedent situations for the behavior)? • What will you do instead? • Sum up the goal and the plan together.

  12. Conclusions Change is hard. We need to own a goal and have motivation to change (“buy in”). Need to think about relapse prevention. Targeted social support is essential and may involve a biopsychosocial model.

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