Substance Misuse Treatment - Essay Example

Substance Misuse Treatment The last 50 years has seen significant changes in the ways and methods that are used to treat the client that has enteredthe substance misuse program. Sociological forces of poverty, racism, sexism, and the widespread availability of drugs have mandated that the public apply newer and sounder treatment methods. Early identification of substance abusers has brought more clients into the multi-tiered system currently modelled in the UK. However, it is not without its shortcomings. Access to services may be limited based on race or gender, and under-qualified providers may be less than adequate to appropriately deal with the magnitude of the problem. The UK model for substance misuse treatment is a 4-tier system that relies on early intervention and accurate assessment. "Tier 1 interventions comprise drug-related information and advice, screening, assessment, and referral to specialised drug treatment" (JAH, 2007, p.2). These referrals come from hospital workers, emergency room staff, social workers, and the criminal justice system. Intervention at this point will involve drug screening, assessment, advice, and a referral to a specialized drug program. However, according to Treatment Tiers (2007, p.2), "Generic service staff rarely receive drug training. To enable generic services to provide Tier 1 drug interventions, commissioners may need to commission specific training or work with mainstream systems to integrate drug training into their vocational training". If the UK model continues to utilize the Tier 1 providers, additional resources should be dedicated to additional training and services. Tier 2 intervention is a more professional approach than Tier 1 with more complete assessment and referrals to psychosocial interventions. This tier works to motivate the client into a treatment program and is staffed and developed by community drug workers and health care professionals. "Tier 2 interventions require competent drug and alcohol specialist workers who should have basic competences in line with DANOS 22" (JAH, 2007, p.3). The competency would range from needle exchange programs to offering and administering brief psychological interventions. Tier 3 is a complete assessment and community based treatment program. Though the programs are occasionally delivered on an outpatient basis, most treatment occurs in dedicated drug treatment facilities staffed by trained professionals. "Medical staff (usually addiction psychiatrists and GPs) will require different levels of competence depending on their role in drug treatment systems and the needs of the client, with each local system requiring a range of doctor competencies" (JAH, 2007, p.4). In addition, Tier 3 focuses on altering the behaviour of the drug user through psychological therapies, and offers harm reduction activities. Tier 2 and Tier 3 share some activities and the treatments may overlap. The most serious abusers of drugs or alcohol will be addressed in Tier 4. At this stage the goal is in-patient detoxification and long-term residential treatment. These consist of half-way houses, residential detoxification, and units specializing in co-occurring problems such as depression or anxiety. "Addiction specialist competencies will be needed for inpatient units for severe and complex problems, but suitably competent GPs can provide support to some units for patients with less complex needs" (JAH, 2007, p.5). At this level there may also be a need for advanced medical attention for liver problems, infections, and HIV. Adequate assessment is a critical factor that benefits both the client and the substance misuse system. It aids the client by introducing them to the programs available and increases their sense of awareness in relationship to their drug problem. The system benefits by appropriately placing the client in the proper treatment setting that will offer the drug user the best chance of success. In addition, the assessment can intervene to invoke a variety of harm reduction activities. These include the coordination of pharmacy based needle exchange programs, as well as the treatment of BBV and other infectious diseases. These harm reduction strategies eliminate the spread of infections as well as deal with it in a timely manner. The four-tier approach to substance misuse is a significant improvement over past methods and is one of the most dedicated approaches in the EU or North America. However, there are barriers that reduce its use among ethnic populations, racial groups, and females. A recent survey indicated that these services are used by 30 different nationalities that speak a total of 36 different languages (Bashford, Buffin, & Patel, 2003, p.6). In addition to the language barrier there are cultural concerns that may preclude a client from seeking treatment due to public embarrassment. Drugs have long been associated with the disadvantaged and this stigma discourages entry into treatment. Biases within the system on the part of health care workers also contribute to racism and sexism. The barriers to seeking treatment are also exaggerated by a lack of public education and awareness about the options available. According to a survey by Bashford, Buffin, and Patel (2003, p.7), "Only 10% of respondents have experience of using drug treatment services and of these most report that their experience was negative". It is clear that to break the cycle of drug use there will need to be education programs, as well as employment opportunities for the disadvantaged that fall into the realm of substance misuse. This educational and public awareness effort must be "able to be understood in different community languages; using formats for different abilities including sign language and audio visual resources; and utilising Black and minority ethnic media" (Bashford, Buffin, & Patel, 2003, p.45). In addition, communities need to get behind and involved with the drug treatment program. According to the Home Office Crime Reduction Centre, "Some communities try to prevent drug treatment services from being provided in their area by exploiting planning rules and local media" (Burgess & Cole, 2005, p.64). Public awareness and public attitudes need to be more open to the treatment options available. Only then will the solutions to the low rate of usage be found, and cultural and racial biases can begin to be eliminated. In conclusion, the substance misuse model in the UK is a significant step towards solving Britain's drug problem. There is a necessity for health care workers to have adequate competency at every level of treatment. In addition, clients need complete and competent assessment to assure a successful outcome. Though there is some criticism to be levelled at the bias within the system against ethnic groups, blacks, and other minorities, the ineffectiveness of the system is in the lack of public awareness and the cultural acceptance of the substance misuse issue. References Burgess, R & Cole, I 2005, Passport to community engagement, Home Office Crime Reduction Centre, London UK Bashford, J, Buffin, J & Patel, K 2003, Community engagement: Report 2 the findings, Centre for Ethnicity & Health, University of Central Lancashire JAH 2007, Tiers of treatment in the substance misuse system, viewed 19 May 2008, < www.bracknell.gov.uk/tiers-of-treatment-in-the-substance-misuse-system.pdf> Read More