The Problem of Drug Abuse - Term Paper Example

Introduction and Purpose of the Study The problem of drug abuse has been something that has existed for centuries. It has escalated into one of the major dilemmas of society which shows little to no signs of dwindling anytime soon. Different institutions whether government-financed or otherwise aim to provide solutions to this imminent matter. Drug use has been attributed to a plethora of social and economic troubles. It has been the culprit for families being torn apart due to the lack of regard that drug-users show to their loved ones. The felonies that have been committed by people under the influence led to some of the most heinous crimes that a decent person could not have been capable to do were they in their proper state of mind. Among the most rampant type of illegal drugs proliferated on the streets is cocaine. Cocaine is described as a potent drug that primarily stimulates the brain and causes intense addiction. The two forms include hydrochloride salt and freebase which can be taken intravenously or through snorting. The type which can be smoked is what is referred to on the streets as crack. Its mixture with alcohol is among the most common causes of substance related deaths (Medline Plus, 2009). The current upsurge of the number of people using cocaine had increased severely over the past years. No longer is it concentrated on the streets and on urban jungles but had reached the suburbs and its inhabitors. They range from nondescript suburban teenagers to other members of the household. The study titled, “Patients’ Perspective on the Process of Change in Substance Abuse Treatment” conducted in 1995 is included among the researches funded by NIDA. The bearing of the study is that it focuses on the perspective of the patients and their own opinion of their recovery and the process of change they will have to undertake. This is a different approach as we are often more focused on the treatment itself and the estimation that they should quit right away or go cold turkey. This is perhaps one of the root causes why many patients relapse as there are loopholes to the popular withdrawal programs as implemented. Preconceived notions on the welfare of the patients places a barrier that could properly lead to their overall welfare. The study proves to be timely as the current figures of cocaine users has increased and there is much need to address this appropriately for a long-term commitment in keeping users clean and understanding their views. Concealed under other names such as ‘blow,’ ‘california snowflake,’ ‘c,’ ‘devil’s dust,’ ‘happy dust,’ ‘nose candy’ and ‘bopper’ among many else, cocaine is the number one abused stimulant drug in the United States currently including most European nations (Bickerstaff, 2009). A better understanding of the spheres that surrounds drug abuse must be well understood to be able to come up with the most sensible solution. The aspect of the law which seeks to halt the sale of drugs is already set in stone with already laid out punishments implemented by those in authority. Yet, it must also be regarded that as long as there are people who purchase it then they will traverse all bounds to grab a hold of it. The underpinning problem that has a more effectual long-term call is to be able to provide a tangible treatment for people who are abusing the substance. This way, it can prevent more unwanted events as well as ensuring the societal wellbeing of more people. Review of the Relevant Literature Patients’ Perspective on the Process of Change in Substance Abuse Treatment Lovejoy et al. The study, “Patients’ Perspective on the Process of Change in Substance Abuse Treatment” by Lovejoy et al. is geared towards a deeper understanding of the vital yet undocumented area of substance abuse. It seeks to provide a deeper analysis on the points of view of the patients subjected to a specified and rigorous process impelemented by the researchers. The focus of the study was on the methadone patients and their views of the treatment for cocaine abuse. This is important for it is grounded on the theory which is based on self efficacy, an integral factor in substance abuse treatment. More literature is needed to address this problem sufficiently and this is the most important goal of the research. They have employed a qualitative approach in developing the process and the consequent conclusions of the enforced investigation through various techniques. The administered treatment was adopted from “Richard Rawson’s neurobehavioral model...developed at the matrix institute.” The patients were encouraged to discuss in length the aspects of the process they found most effective , the changes they have made and the reasons on how they made them. The specific questions addressed include (Lovejoy et al., 1995): 1. What motivates them to enter and remain in treatment? 2. What motivates them to change and how does the process of change occur? 3. Which specific elements of treatment do they find most effective? The sample population of 17 represented a much larger sample of so-called treatment completers and included the 10th-26th patient. Women were not the majority gender among the patients. Their ages ranged from 24-50 with 41% consisting of Hispanic ethnocultural background and 41% African-American. A total of 59% were not able to secure a high school diploma and 70% do not have employment. Furthermore, 41% have been jailed for about 6 months or more while 47% informed of being part of some illegal activity before they have entered treatment. Their usage of crack is between $3-$100 on a daily basis with $35 as the median. All of them have been users for a minimum of five years with 41% exceeding 10 years. More importantly, 70% of them had not received any previous treatment besides methadone or that prior attempts have proven to be unsatisfactory which led to their ensuing relapse (Lovejoy et al., 1995). The treatment contains a structured 6-month long process of 5 times every week personal and group dynamics. It is founded upon psychoeducational orientation with individual and group meetings for relapse deterrence and other cognitive-behavioral techniques that are tested for drug abuse prevention. It also includes positive reinforcement through interpersonal and concrete reinforcement to encourage the patients to attend the rigorous process. Concrete reinforcement was provided through the handing of reward for their feats. Each member of the population receives $2.50 for attending each session. This is to motivate them through positive concrete reinforcement. Certificates and other awards are also given when they have reached certain goals that were previously set through the course of their treatment much like what is done in alcoholics anonymous groups. This is to encourage motivation and show appreciation for the things that they were able to accomplish. The themes of the result was identified between patient perception of treatment and patient perception of personal change. In relationship with therapist, 82% reported having strong attachment to their therapist. Most of them initially started with mistrustful regards for their shrinks but eventually took a liking through their hours-long therapy sessions. About 77% reported having high levels of trust and confidence as most of the therapists were perceived to have shown care for their patients. This was a breakthrough as it allowed the patients to let down their guards and talk to them and be able to tell them their stories and remove the doubt that they are being experimented upon and that they cannot trust the therapists with the things that they reveal. This was an effective tool because patients were able to avoid reverting as there is a figure that prevents them from repeating their mistakes. Patient Perception of Treatment The other session which was in group paved the way for the development of camaraderie and affinity among the population.. Only three patients reported mistrust as they feared they would be the topic of gossip outside the therapy room although there had been no precedent of this ever happening. The other reason was that two patients quit the group dynamics was that they felt that other members of the group were blatantly lying during the forum regarding their intensity of drug use and resulted to their feeling of discomfort (Lovejoy et al., 1995). Being in front of other individuals who have the same problems let them appreciate that they are not alone in their struggle. A bondage is formed because they are all going through the same experiences and they all have the same history. Another important aspect of the treatment which the patients have praised is the frequency of the sessions and the positive reinforcements given even with only short-term goals they have attained. Because it was a daily program, the participants had to keep in mind that there is something for them to do regularly and that is attending their sessions which is a way for them to fight off boredom and depression and the other was the adherence to a daily calendar which records their usage. Instead of enforcing that they go cold turkey, the patients were encouraged to keep a journal and put a red mark on the days that they did not use cocaine. It kept them on track to be able to monitor their progress with baby steps at a time. Simple praises such as a pat on the pat for changes in their manners was also regarded as a positive aspect of the treatment in general. The most effective relapse prevention technique as cited by the population was thought-stopping. A total of 12 patients reported that they have employed the technique and has proven it to be effective. Improvement on their personal efficacy and personal hygiene becomes apparent among the population. Handling their money and pre-emptively avoiding people and situations which could lead to cocaine use must also be kept in mind. The enjoyment of favored activities to avoid stimuli, keeping active and being preoccupied with other activities are imperative in the avoidance of reverting to substance abuse. being educated on the negative effects of cocaine use were also significant in the changes that occurred to them (Lovejoy, et al., 1995). Patient Perception of Treatment Progress In the course of the interview process for the study, five questions stood out as the themes for their treatment progress, they are; 1. Cocaine use, 2. Motivation, 3. Coping with negative emotions, 4. Interpersonal relations and 5. Self-esteem and self-care. Fifteen or 88% of the total population hasreported that they have cut on their cocaine use by 50% with five among them already in a month or so abstinence before the conclusion of the treatment. To prove its verity, a urine toxicology test was conducted and certified this to be true. The patients themselves have recognized drastic changes in their body especially in the way that they look. “Patients noted that they had gained weight, and that they felt stronger, more clear-headed, less deppresed, and more at ease with others” (Lovejoy, et al., 1995). Some of the minor lapses in the study were the three patients who regarded their therapists to be too strict in their patient-therapist relationship. Regardless, these patients have exhibited a workinh relationship with their therapists despite their complaints. The stringency of the process was also among their objections in the treatment. It must also be noted that there are few women included in the study. The primary limitation of the study is due to its diminutive sample size which points out that the study must be taken as exploratory in nature and qualitative in method. The interviews which composed the entirety of the research only contains the perceptions of the patients who were able to complete the process. The constraints of the patients in their ability to relate their experiences is also a restriction. Thus, it cannot be said that all their insights were properly recorded (Lovejoy et al., 1995). Although the entire process was not a hundred percent in assuring that all the patients will be drug-free, the 50% who reported reduction in cocaine use is already satisfactory. Progress, however miniscule, is still better than having no progress at all. Accordingly, cocaine is reported to be one of the hardest illegal drugs to quit which makes this development a considerable accomplishment. Their change of motivation signify an overall change that includes personality and confidence enhancement. They have manifested changes including those that are emotional in nature. Hence, they indicated that they are more aware of their emotions and through this they have more control on their reactions. Instead of reverting to cocaine, which was their habit previously, the techniques taught in the course of the study gave them more power to manage their lives. The motivation that was relegated by the therapist for the continued progress of the patient indicates that social corroboration yields constructive effects for such cases. They should not be antagonistic toward the patients as will serve as sympathetic figures that stand behind the progressive development that they had to go through. Cocaine Abuse: Review of Current and Experimental Treatments Herbert Kleber and Frank Gawin Treatment for cocaine abuse is limited comparative to the need it entails. There have been a few studies which address possible treatments for cocaine users. The most common problem indicate the nature of the drug as a psychological dependence drug. This usually means that there are no withdrawal symptoms that quitters will have to go through as it is not neurophysiological. It must be considered that there are various levels of abuse and the patient’s own desire to undergo treatment. There are diverse indications to the disruptions of social responsibilities that users go manifest. The most common cause of drug abuse is for the individuals to void painful emotions and psychiatric indications as previously indicated. Gawin and Kebler (as cited in Grabowski, 1994) maintained that it is important to diagnose and identify substance abuse from psychiatric ailment instead of immediately attributing it to drug use. This should be followed by distinguishing depressive symptoms from episodes of cocaine use. This is where the role of the therapist is vital in diagnosing the differences through accumulating historical backgrounds of the patients. Psychotherapeutic treatments for cocaine users were classified into three categories. (1) To help the abuser recognize deleterious effects of cocaine use and accept the need to stop it. Anker et al.’s treatment approach emphasizes this area. (2) To help the abuser manage impulsive behavior in general, and cocaine use in particular; for example, exploring ways to disassociate the abuser from cocaine use situations and cocaine sources. Such supportive functions are emphasized in Segel’s treatment approach. (3) To bring the abuser to an understanding of the functions that cocaine has played in his life and to help him serve these functions without drugs. For example, cocaine can serve narcissistic needs through the glamor associated with its use (or by direct pharmacological effects) needs for identity via the social networks and drug using subculture associate with it and anaclitic needs via possible facilitation of intimate interpersonal interactions, among many others The need to appropriately tackle the issue of drug abuse is founded upon the need for research to be able to ascertain and enforce the best way to address the situation. The need for further studies give an extensive understanding on the way that the patients think. This is imperative because their input on the effectivity of the process identifies whether the treatment conducted has its merits and can be adopted by other groups Cocaine Changes: The Experience of Using and Qutting Dan Waldorf, Craig Reinarman and Sheigla Murphy The idea that cocaine is innocuous has become detrimental to the process of preventing the dissemination of the drug into a larger market. Known to have the potential for being highly addicting, the best advice is to never try it in the first place. In the 1970s, cocaine users did not post health problems that were pressing at the time and seemed to controlled without causing problems to the users. But in just a few short years, a new outlook on cocaine and its effects have been realized. It is categorized between physical and mental where physical problems include convulsions and seizures among others. Cases of angina has been recorded for users and quitters of the drug including the more minor nasal problems such as deviated septums and other infections. While mental problems include paranoia, hallucinations and insomnia (Waldorf, Reinarman, & Murphy, 1991). Suffice to say that negative emotions is among the most occuring problem among patients of substance abuse. The need of drug abusers to be more aware and be able to control their ill-feelings by recognizing them and relating them is importan in the process of recovery. This instigates the rationalization that there is a need for support and someone to be able to talk to about their life. Anger, whichis among their most unbridled emotion is now something that they should be able to handle through anticipation what could possibly provoke them. Parallel to this their interpersonal relationships are also of the utmost import. The extension of treatment which is aimed towards a long term process of withdrawal is a goal that has been elusive for the government, institutions, families and among drug abusers themselves. This is an aspect which must be recognized. The problem of relapse which is very common among cocaine dependents is the most crucial aspect that needs to be dealt with. This is why the study was conducted, to give a better understanding of how to take on the issue. Psychological education is indispensable because it gives them a much wider understanding of the possible health and psychological problems that they will encounter. A rigid structure for rehabilitation makes the possibility for relapse less likely to happen. This is because they are given particualr schedules which leaves little time for them to be able to make time for drug use. Deductive reasoning would suggests that this is positively a way to address the issue of drug abuse treatment. Motivation, strategies and actions are important to ensure that a cocaine should eventually leave drug abuse as a thing of the past. The beauty of the book written by Waldorf, Reinarman and Murphy as that they did not seek to alter the behavior and treatment of the cocaine users. Their main goal was to record findings of a multi-dimensional concept and reality of cocaine use. They chose to immerse themselves with people who are in the lifestyle. Through interviews they were able to get a closer look into the people and the life that comes with it. They never intended to change the people that were included in their study but through it they were able to get a better perspective of the possible solutions because they saw the deeper root cause for most of the problem. Cocaine: Abuse and Addiction Nora Volkow Statistics show that about 15% or one in six Americans used cocaine at least once by the time they are at the age of 30 while 7% have tasted it before they finish high school. New research show that its effects on the brain and other damaging consequences must be disseminated to inform people on what it can do. One of the factors being considered for a predisposition to such psychoactive substance abuse is genetics. Innovative technologies show the capability to identify the genetic factors in the brain which is necessary for the treatment of cocaine addiction. The National Institute on Drug Abuse (NIDA) has remained a vigilant staple on the search for approaches in this public health concern (Volkow, 2009). As such they have been the primary force in addressing this issue with propriety. The popularity of cocaine reached its peak during the 1980s and the 1990s but it had been around for about a thousand years. It is derived from the leaf coca which is one of the oldest psycoactive drugs ingested by people. A pure matter from ‘Erythroxylon’ was used for treatment of different ilnesses. It is also used legally by physicians as anesthesia for minor surgeries. Colombia was among the primary producers of the plant and after a reduction in the production of the crop, they were one of the most affected. Considered to be a Schedule II drug, cocaine is one of the most addicting type of substances. Tolerance for the substance develops after prolonged usage and pleasure diminishes regardless of the amount. Accordingly, its side effects will continue to show including convulsive tendencies (Volkow, 2009). Cocaine Use: 2002 and 2003 National Survey on Drug Use and Health It is important to understand the most current available statistics of cocaine abuse as gathered by reliable groups. The National Survey on Drug Use and Health (NSDUH) conducted a study where they queried people aged 12 or above about their abuse of substances which includes cocaine. The organization classifies through the use of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV) which includes withdrawal symtoms, tolerance, the situations during usage, run-ins with the law and how it affects their social obligations in all aspects. The years incorporated in the study recorded that 5.9 million or 2.5% of those aged 12 or above and over 2.1 million or .9% have used cocaine in a span of one month. While those aged higher i.e. 18-25 recorded higher use rate in the year the study was conducted. A trend was seen that men were more likely to use cocaine than women. Also, Asians were seen to be the lowest predilection among all racial groups (National Survey on Drug Use and Health, 2005). From National Survey on Drug Use and Health (2005) The knowledge of the true state of the extent of drug abuse in the country is indispensable to be devise the most effective course of action that the government, institutions and individuals should take. To be able to see the concentrations of the most affected areas and people, whether in age or ethnicity, gives a multifaceted comprehension of the situation. The organizations that are concerned in the implementation of these programs are well-equipped when there are more studies that fortify their proceedings. . The problem of substance abuse and its effects to the society stimulates government bodies to implement actions that puts light on the issue. The hand that the National Institute on Drug Abuse has played becomes the basis for many treatments and approaches on drug treatment. The importance for rehabilitation participants to avoid relapse now becomes the most imperative next step. All these play a part in the overall welfare of the country and the communities that it comprises. Bibliography Bickerstaff, L. (2009). Cocaine: Coke and the War on Drugs. New York: The Rosen Publishing Group. Grabowski, J. (1994). Cocaine: Pharmacology, Effects, and Treatment of Abuse. Maryland: NIDA Research Monograph Series. Kleber, H. D., & Gawin, F. H. (1994). Cocaine Abuse: Review of Current and Experimental Treatments. In J. Grabowski, Cocaine: Pharmacology, Effects, and Tretment of Abuse (pp. 111-129). Maryland: NIDA Research Monograph Series. Lovejoy, M., Rosenblum, A., Magura, S., Foote, J., Handelsman, L., & Stimmel, B. (1995). Patients' Perspective on the Process of Change in Substance Abuse Treatment. Journal of Substance Abuse Treatment , 269-282. Medline Plus. (2009, December 1). Retrieved May 31, 2010, from Cocaine: http://www.nlm.nih.gov/medlineplus/cocaine.html National Survey on Drug Use and Health. (2005). Cocaine Use: 2002 and 2003. The NSDUH Report . Volkow, N. D. (2009, December 30). Cocaine: Abuse and Addiction. Retrieved May 31, 2010, from National Institute on Drug Abuse: http://www.nida.nih.gov/ResearchReports/Cocaine/Cocaine.html Waldorf, D., Reinarman, C., & Murphy, S. (1991). Cocaine Changes: The Experience of Using and Quitting. United States: Temple University Press. Read More