Substance Abuse Treatment Inside Corrections - Term Paper Example

? MULTICULTURAL ABUSE TREATMENTS (Substance Abuse Treatment inside Corrections) of (affiliation) The drug menace continues to hound society, and it has pervaded to almost all sectors already. A sustained effort to control it has produced variable results only, partly because wrong approaches had been used in the past where a general approach was utilized in substance abuse treatments in the sectors of society that are adversely affected. The old paradigm was to be culturally-neutral in prescribing ways to control substance abuse, primarily alcohol and other drugs (AOD) where effort was maintained to project a politically-correct program that seemingly appears to be not in any way smacks of racial discrimination. However, a new thinking has taken root in those who provide support and assistance to substance abusers that take into account the nuances inherent in a culturally-diverse society. This new paradigm produced what is called as “recovery movement” that includes the involvement of other stakeholders within the larger community. The old service delivery model was proven untenable, as people respond differently to substance abuse treatment based from their own cultural and ethnic backgrounds. Through this lens, prevention, cessation, detoxification interventions have now adopted this new approach. Multicultural realities are now recognized as having a big influence, and ultimately the eventual success, of any program. This is shown by the requirement that counselors need to undergo additional training in cultural and ethnic sensitivity, to enable them to administer these programs much better with higher chances of preventing recidivism among abusers. The new mentality is to treat abusers as victims and not as perpetrators of a crime, in light of the new thrust of an enlightened criminal justice system. Keywords: abuse, culture, ethnicities, language, programs, substance, treatment Introduction The drug menace has gotten worse over the years, with those who abuse illegal drugs in almost all spheres of society. Whether in high schools, in colleges and universities, in workplace situations, in non-profit organizations or even in the military, drug abuse has become prevalent. It has put a huge strain on government resources, and the fight against illegal drugs has not seen any improvement despite the best of efforts by many government agencies tasked in the “war on drugs” as it has become a very lucrative industry. People turn to drugs for a variety of reasons, in most instances trying it out first just for curiosity, but then people get hooked and they cannot shake their addiction anymore. It takes great willpower to desist from using illegal drugs and has been a big drain on government resources and also on the various agencies tasked to eradicate it. Some people turn to drug pushing in order to earn money while others use it for the “high.” Whatever is the underlying reason why a person gets hooked on drugs, there is always the heavy task of rehabilitating these drug addicts through the process of drug treatments, in case they want to regain back their normal lives. The criminal justice system, anchored on the three pillars of law enforcement by the police to catch drug criminals and users, the judiciary which is charged with trying those accused of the crime, and the corrections system which seeks to put in prison those found guilty, and eventually to rehabilitate all the drug victims, has fought a losing battle against this insidious menace which destroys lives and in turn, destroys the social fabric. A variety of approaches have been utilized in the later part of this fight against illegal drugs, that is, helping drug addicts and illegal substances abusers shake off their habit. This paper examines the techniques used to deal with abusers inside the corrections, based on multicultural realities. Discussion People respond differently to different approaches, as no two persons are exactly alike. The trend in health care today is what is called as “cultural medicine” or “cultural nursing” when the health care provider takes into consideration the cultural beliefs and values of the patient. It is not exactly a new or entirely novel approach, but is merely cognizant of the realities when it is a case of patients helping their own recovery using their ethnicity. Patients respond better and also more warmly and with better reception to providers who come from the same background. It is a better approach because this deeper cultural understanding hastens the healing process. It is only natural for patients to trust more a health care provider who comes from their same cultural background because it helps clear up a lot of issues associated with someone who does not share the same ethnic background. Patients who are trustful tend to follow directions or instructions more faithfully, improving their chances of better health outcomes when the patient's cooperation is crucial to the recovery. Misconceptions and misunderstandings can be avoided if a provider knows how the patient feels and thinks, anticipating reactions, to serve and care better. Cultural competence is a necessity in drug rehabilitation, cessation, and detoxification programs. The trend towards multicultural approaches involves not only practices in medicine, but in many other areas of life as well, due to changing demographics brought about by a higher level of immigration and movement of people these days. Multiculturalism pervades everywhere, in workplaces, in the military services, in hospitals, in rehabilitation centers, and also within the walls of the corrections in the criminal justice system. The idea is to help drug abuse victims get back on their feet faster and lead them back towards normal lives and re-integration into society. There are several important issues associated with satisfactory and successful outcomes of drug abuse treatments which are related to better cultural or multi-cultural competence of the health and social workers. Several decades ago, the American Psychological Association (APA), which is the primary professional organization that deals with mental illnesses and impairments, did not give much importance to the cultural implications present in the client base. It was of the opinion drug rehabilitation programs are better viewed as culturally-neutral and to be politically correct, to avoid any unnecessary suspicions or accusations of cultural or ethnic bias. However, clinical experience indicated otherwise, that being culturally sensitive helps produce the much-better outcomes expected when dealing with ethnic or cultural minorities in drug treatments. Speak the same language – this is perhaps the most important criteria when evaluating a therapist in relation to drug addiction patients. The same language eliminates the most crucial or critical barrier that must be surmounted when dealing with minority patients: communications. It also solves a number of related sub-issues, such as speaking the same language helps in a better or more accurate assessment of the patient than is otherwise possible, it creates that special bond between patient and therapist, and lastly, it does away with the need for a language interpreter or language translator, whose presence may present some confidentiality issues to a patient. Speaking the same language promotes mutual understanding, which in turn produces a special therapeutic bond between the patient and the therapist, as it creates the conditions needed for mutual trust to develop. A patient who trusts the therapist is more amenable or susceptible to following instructions on drug cessation processes; he will not be hesitant to express his deepest feelings and thoughts, providing the right conditions for making a more accurate assessment. Avoidance of racial profiling – this is another important consideration, because this is a fairly common situation, in which drug abusers are categorized based on racial stereotypes. It is a hindrance to successful treatment, as it can lead to wrong assumptions and even a mis-diagnosis. Although in most instances, some minorities are over-represented in drug treatment programs, it is still vital to see the patient as a unique individual and a special person deserving of the correct approach to treatment that takes into account his racial or ethnic background, regardless of those circumstances leading to his drug addiction, such as socio-economic factors like poverty, child abuse, lack of a proper, formal education, and coming from a broken family. A good approach to substance abuse treatments must take into account the diversity of a client base or groups. Prevents feelings of alienation – this is a very common cause of drug abuse, when these addicted people are asked why they turned to drugs in the first place. Alienation comes from the feelings of anomie, or normlessness, an idea propounded by the famed French sociologist Emile Durkheim in his 1893 book publication, The Division of Labor in Society, at a time when the Industrial Revolution caused so many changes in society, that some people were unable to cope. Understanding anomie as a fairly-modern phenomenon due to the rapid changes in society helps psychologists and therapists to implement culturally-suitable approaches to drug therapy because it emanates from the loss of values and traditions. Along this line, successful therapy takes into account the cultural identity of a substance abuser to tailor-fit any drug rehabilitation program to address this feeling of angst, anxiety, alienation, and drift by making the abuser feel a belonging. Anomie theory views substance abusers as victims of society and not as deviants; people who are unable to cope and thereby need special consideration and assistance to regain cultural roots. Contextual settings – people who undergo drug rehabilitation programs inside a prison or a correctional system do so under compulsion. These are oftentimes involuntary detoxification programs that form part of their court sentencing, or in most cases with juvenile violators, forms a portion of their plea bargaining agreements to reduce their prison time. In other words, they are forced or subjected to in-prison inpatient hospitalizations, unlike those in private institutions in a non-profit volunteer rehabilitation program, where enrollment is optional on the part of abusers. Cultural competence increases the odds of success when abusers view their treatment as part of a bigger effort to rehabilitate them, and not as punishment or being singled out as ethnic minority. Good rehabilitation programs consider multicultural variations in patients, and provide their care in a culturally-sensitive setting where minorities do not feel isolated or excluded from a group. Better suited to cultural norms – every culture has its own unique beliefs, practices, and values with regards to certain things in life, those that really matter, such as birth, marriages, and death. Included in this culturally-defined set of beliefs is the attitude of an ethnic group about the presence and prevalence of certain ailments, including drug addiction. Some do not see it as sort of a medical issue, that addiction is not a disease in itself, or it could have been caused by spirits. Understanding drug addiction within the lens or viewpoint of a patient's ethnic identity can help in rehabilitation programs more effective by making compliance easy for the patient, providing the critical emotional support and encouragement to continue with it. A new emphasis on multicultural counseling is the new paradigm, which provides a bridge to good outcomes and eventual recovery. Cultural experiences determine coping styles, family support systems, social adjustments, and the stigma in addiction (Center for Substance Abuse Treatment, 2006). Prevention interventions – a culturally-based approach to substance abuse prevention or protection intervention programs work better when individual cultural or ethnic backgrounds are taken into account. This had been the approach taken by the U.S. Center for Substance Abuse Treatment, which is the federal agency tasked to oversee various programs dealing with ethnic minorities in the country. Programs for target populations, such as native Americans, the black Americans, Asian-Americans, Hispanics, and inner-city adolescents have been remarkably good at prevention and protection for these vulnerable population segments. Cultural competence is a good way to address self-perception issues leading to substance abuse (alcohol and illegal drugs) because these programs are tailor-fitted to the unique social needs of each target population. The risk factors are addressed on both individual (familial, genetic, emotional, attitudinal, etc.) issues and also environmental issues (family, school, peer groups, community relations, and economic system) prevailing within the larger social sphere. Cultural responsiveness can tap into familial and social resources to reduce risk factors by utilizing ethnic traditional values (Gaw, 1999). Self-empowerment enhanced through culture – majority of people who abuse substances often have low self-esteem, resulting in dysfunctional behaviors. Cultural competence in various intervention programs seek to remedy this, and substance abuse programs go together with usual family therapy in terms of emotional support, resulting in what is termed as the new “recovery movement” that includes the larger community (Krestan, 2000). The previous service-delivery model in fighting alcohol and other drug (AOD) problems encountered in families and in society was replaced with new awareness and renewed emphasis of involving the community composed of multiple ethnicities and cultures into a model of community development (Gordon, 1994). This new paradigm maximizes the influences of culture and ethnicity within the larger framework of effective design and program implementation, thereby increasing the effectiveness of any substance abuse treatment programs due to a higher level of acceptance, credibility, and legitimacy using cross-cultural knowledge and skill sets. Dropout rates can be reduced among its various ethnic groups rather than treat the whole client base as one homogeneous group. The big idea is to respect the norms, values, and beliefs of a target culture group, especially with regards to how that particular group perceives and defines social problems like AOD (Freeman, 2001). Conclusion Some techniques used within particular ethnic target groups include the use of narrative approaches (Asian-Americans), the “broken circle” concept and “centering techniques” (for the native Americans), and group counseling (for Hispanics. Chicanos, or Latinos). Adolescents are from a vulnerable population segment and some of the techniques used are violence and anger management, avoidance of problematic or dysfunctional behaviors, and social training for newer skills and better adjustments during the sensitive growing-up period in their lives. One of the more specific program is the guided adolescent problem solving (GAPS) technique. The criminal justice system today is more enlightened compared to the prior decades; its new emphasis is no longer just on punishment but rehabilitation and re-integration. This new model is reflected in adoption of more culturally-sensitive substance abuse treatment programs because a uniform, general approach simply does not work, due to multiple ethnicities embedded in a diverse society. A nuanced approach can likewise reduce recidivism among inmates who use or abuse alcohol and other drugs while inside a penitentiary and when freed (Vacc et al., 2003). References Center for Substance Abuse Treatment (2006). Substance abuse: Addressing diverse populations in intensive outpatient treatment. Rockville, MD: U.S. Substance Abuse and Mental Health Services Administration. Freeman, E. M. (2001). Substance abuse intervention, prevention, rehabilitation, and systems change strategies: Helping individuals, families, and groups to empower themselves. New York, NY: Columbia University Press. Gaw, A. C. (1999). Substance abuse prevention in multicultural communities. The American Journal of Psychiatry, 156(8), 1289. Gordon, J. U. (1994). Managing multiculturalism in substance abuse services. Thousand Oaks, CA: Sage Publications, Incorporated. Krestan, J. (2000). Bridges to recovery: Addiction, family therapy, and multicultural treatment. New York, NY: Free Press. Vacc, N. A., DeVaney, S. B., & Brendel, J. M. (2003). Counseling multicultural and diverse populations: Practical strategies for counselors. New York, NY: Psychology Press, Limited. Read More