Domestic Violence and Substance Abuse Treatment

November 23rd, 2015 by hesty No comments »

Every 15 seconds a woman is subjected to domestic violence in the United States. Domestic violence can be defined as a pattern of abusive behavior that is used to gain or maintain power and control in an intimate relationship, such as marriage, dating, family, friendship or living together. Anyone can be a victim or perpetrator of domestic violence.

Keeping this in mind, we will be focusing on male batterers and female survivors of domestic violence since this is the “typical” scenario and will be seen most often in treatment facilities. We will discuss substance abuse in both the batterer and the survivor.

When most people think of the relationship between substance abuse and domestic violence they picture an alcoholic husband beating his wife, and while this is one case, it is most certainly not the only. This case suggests a direct correlation between substance abuse and the occurrence of domestic violence. However, most studies show that while they are linked the relationship is not that straightforward.

The problem with directly linking the two issues together is similar to problems in dealing with co-occurring disorders (dual diagnosis) in that the question that is most often debated is which one came first, the drinking or the violence. Even though according to the U.S. Department of Justice study reports that 61% of domestic violence offenders also have substance abuse problems, we must remember that the violence may not necessarily be a consequence of the substance abuse and that the substance abuse could be a result of the violence. However, as with co-occurring disorders, it is imperative that we address both issues and not focus too much which came first.

Substance abuse in the batterer is what most people will think about when substance abuse and domestic violence are mentioned together so we will discuss this first. The characteristics of a batterer are very similar to the characteristics and risk factors you would find in substance abusers. These characteristics include: witnessing parental violence, parental substance abuse, corporal punishment, depression, socioeconomic hardships and an intense need for power and control.

Despite the difficulty of finding an exact cause and effect relationship between substance abuse and domestic violence, experts have organized batterers into three categories in order to improve their treatment. The first category is “Typical Batterers”. Typical batterers are characterized by keeping the violence they inflict in the home, which will be less severe when compared to other batterers, and are usually not substance abusers. They will also most likely have no history of legal troubles, mental illness and will usually be remorseful for the violence. The second category is “Antisocial Batterers”.

The characteristics of the antisocial batterer include being extremely abusive, having some mental health issues, may be a substance abuser and will most likely have difficulty completing domestic violence program without being provided additional services. The third category is “Sociopathic Batterers”. The characteristics of a sociopathic batterer include being the most extremely violent, heavy substance abuse, tremendous difficulties in treatment programs, little or no empathy for others, no remorse for the violence inflicted and the most likely of the three categories to have had legal issues.

Treatment for a batterer with a substance abuse problem can be much more difficult than the already difficult treatment for a person with just a drug or alcohol addiction problem. The most common model for batterer intervention is the Duluth Model. The Duluth Model is a behavioral change model that seeks to alter the batterer’s behavior by confronting his denial, his need for power and control and helping him realize his alternatives to the violent behavior. This model is a community-wide model that involves many people including law enforcement which ensures that the batterer will be arrested while the survivor is protected.

Like I said above, when most people think of substance abuse and domestic violence they only think of the addiction in the batterer. However, survivors of domestic violence are also likely to present in treatment programs with drug or alcohol problems. In fact, in 2002, the Department of Justice reported that 36% of survivors in domestic violence programs also had substance abuse problems.

Again, there is no direct cause and effect relationship between a survivor’s addiction and the domestic violence although it is commonly thought that the violence increases the likelihood that a survivor will abuse alcohol or drugs. While this may not be the case for all survivors with drug or alcohol problems, both the domestic violence and the addiction have an extreme impact on the survivor’s recovery from both and the treatment provider needs to be aware of this.

When a client presents for substance abuse treatment and reports a history of domestic violence, especially a recent history, there are several steps that a treatment provider should follow. First, the provider should make sure that the client is in a safe environment and that they understand that while they are at the facility they are safe. Second, the provider should never doubt the survivor’s story, even if there are discrepancies. If a client feels they cannot trust the counselor or provider they will leave treatment and put themselves back in dangerous situations. Finally, during the assessment the provider should identify the client’s options and the perceived benefits and consequences with each option and then have the client work on a safety plan. This will involve the client and make them feel involved in their treatment and encourage them to stay and feel as though they can accomplish their goals. One of the most important things to remember when working with survivors is that their safety, both physical and emotional, is the most important obstacle in the initial stages of treatment to be addressed. If it is not addressed immediately the likelihood of the client staying in treatment is very low.

Domestic violence and substance abuse are separately two of the most devastating issues in American society today, but combined they are significantly worse and more attention needs to be paid to the relationship and treatment of the two. It is vital to properly screen and assess clients as soon as they present for substance abuse treatment so the next steps of the treatment provider will be the correct ones. There are many resources available on domestic violence and addiction including SAMHSA TIP 25, the National Coalition Against Domestic Violence, the Tennessee Association of Alcohol, Drug & other Addiction Services, and Women’s Rural Advocacy Programs.

Substance Abuse Prevention

November 16th, 2015 by hesty No comments »

A leading substance abuse center recently urged the nation’s doctors to focus more closely on alcohol and drug use by their patients after finding that more than 9 out of 10 physicians didn’t diagnose alcohol abuse when presented with its early symptoms.

A survey by the National Center on Addiction and Substance Abuse at Columbia University found that physicians felt unprepared to diagnose abuse and lacked confidence in the effectiveness of substance abuse treatment.

When presented with an adult showing early signs of alcoholism, some 94 percent of primary care physicians failed to diagnose substance abuse, the center reported.

And 41 percent of pediatricians didn’t diagnose illegal drug abuse when presented with a classic description of a drug abusing teen-age patient.

The center said that when the doctors were asked to suggest five possible diagnoses for the symptoms, they failed to include substance abuse.

Primary care physicians must stop ignoring this elephant in their examining rooms. Medical schools, residency programs and continuing medical education courses have an obligation to provide the training those physicians need to spot and deal with substance abuse.

Barry R. McCaffrey, director of the While House office of national drug control policy, said he supports the call for additional training of physicians in substance abuse and addiction.

“Families have always relied on their doctors for health care advice. Drug abuse rips families apart. Giving the right advice on drug prevention and treatment can keep a family together,” he said.
Substance Abuse Statistics

The survey found that only about 20 percent of doctors felt very prepared to diagnose alcoholism and 17 percent felt prepared to diagnose illegal drug use. In contrast, nearly 83 percent felt very prepared to identify high blood pressure, 82 percent to diagnose diabetes and 44 percent to identify depression.

Some 86 percent felt treatment for high blood pressure is very effective, and 69 percent felt diabetes treatment is very effective.

But only 8 percent felt treatment is very effective for smoking, close to 4 percent believed it is effective for alcoholism and 2 percent for illegal drug abuse.

The center said 58 percent of doctors don’t discuss substance abuse with .their patients because they believe their patients lie about it. Some 35 percent listed time constraints for not discussing it and 11 percent were concerned they won’t be reimbursed for the time necessary to screen and treat a substance abusing patient.

The report recommended increased education programs for doctors in diagnosing and treating substance abuse, urged state licensing boards to require such training and called on Medicare, Medicaid, private insurers and managed care to expand coverage for substance abuse treatment []

The survey of 648 physicians across the country has a margin of error of plus or minus 4 percentage points, the center said. It also conducted a survey of 510 patients but noted that was done at only selected centers and was not statistically representative.

The Perils of Youth Substance Abuse

November 9th, 2015 by hesty No comments »

The launch of the educational program D.A.R.E., or Drug Abuse Resistance Education, was the structured acknowledgment of a growing youth substance abuse issue in America. As the days of free love and experimentation faded into the background, a realistic look at drug abuse from the United States hit our communities head on, as the Woodstock generation discovered themselves confronted with wellness issues and continuing addictions. Recognizing the detrimental impacts of the drug culture, the government decided to attempt to nip youth substance abuse inside bud by promoting education within the topic at a young age. Sadly, the issue continues these days.

Youth substance abuse is far more pervasive than one may possibly initially believe. The most frequently accessed drug for children is alcohol, with most youngsters dabbling in its use far prior to their 21st birthday. The second most generally applied drug for minors is tobacco. On the other hand, illicit drug you still a massive issue. Marijuana use remains a continuous difficulty for the youth of America, and so known as “club drugs,” just like ecstasy, continue to gain in popularity. The newest trend in youth substance abuse is quickly prescription drug abuse. Pills prescribed for pain relief are simply accessible in medicine cabinets, making them the high of selection for numerous children right now.

Youth substance abuse is really a challenging trouble to tackle. Most experts agree that prevention starts at house. Mom and dad require being honest and open with their youngsters for the topic of drug use and abuse. Some father and mother discover this complicated, particularly if they have had experiences with illegal drugs within the past. Nevertheless, parental silence puts small children in a precarious position. Youth substance abuse is only fueled when young children need to turn to their peers for data about the topic, which generally results inside the transmission of partial or false facts. It’s critical that dad and mom sit their children down to talk concerning the consequences of youth substance abuse. Father and mother will need to list distinct kinds of drugs, the negative impacts the drugs have within the body, plus the legal consequences that drug abuse carries.

Even so, our schools also present an superb opportunity to educate our young children about youth substance abuse. Whilst programs just like D.A.R.E. have received mixed reviews, incorporating drug abuse info into basic health class opportunities makes sure that young children will consistently be informed concerning the risks associated with youth substance abuse. This kind of coursework is often tailored being age appropriate, plus the continuity of education from year to year ensures that the children are getting the correct details at the correct time.