Role of Social Worker and Substance Abuse Essay Example

to be aware of their own thoughts and feelings about substance abuse (Boyle, et al, 2009). As with all of the helping professions, social workers see their fair share of substance abusing clients” (Gassman, et al, 2001).

During the treatment and assessment of drug or alcohol users, social workers must put their own morals and opinions aside in order to properly assess those who are afflicted by addiction (Boyle et al, 2009). Subsequently it is important for social workers to know themselves as individuals and professionals when facilitating those they are trying to help. The social workers’ approach to the client can help determine the foundation for intervention techniques.

However, in order for a social worker to fully understand the client who suffers from substance abuse, it is important to know the neurological effects that the client endures in order to ultimately gain a better understanding of treatment methods. Crossover of Mental Illness and Substance Abuse Mental illness is another major reason why individuals start using drugs and eventually become dependent. Chronic drug abuse may occur in concurrence with any mental illness identified in the American Psychiatric Association (DSMIV).

Some common serious mental disorders associated with chronic substance abuse include schizophrenia, bipolar disorder, manic depression, attention deficit hyperactivity disorder (ADHD), and generalized anxiety disorder (National Drug Intelligence Center). Some people may use drugs on a regular basis as ways to self- medicate themselves if they are dealing with any of these mental illnesses (Hutchinson et al 2007). Co-occurring disorders are very common. In 2006 an estimated 4 million adults met the criteria for both serious mental illness and substance dependence or abuse

(National Drug Intelligence Center).

Addiction whether it is a disease or choice will always be up for dispute. Every day is lived in many different ways within each individual. Substance abuse shares many types with other chronic illnesses. It is also subjective by environmental conditions and behavior, and the capability to respond to appropriate treatment, which may include long-term lifestyle changes. It might be a choice to pick up a drug or drink and use it. It is the widely debated fact is that in all actuality it comes down to choice. After repetitively making the same choice over and over the user’s brain begins to adjust to that choice.

Just like the average person has a morning routine that consists of: turning the alarm clock off, getting up, making coffee, taking a shower. An addict also has a similar routine in terms of their using. Just as the average person doesn’t think about the morning routine the addict doesn’t even think about their using. The user’s brain no longer processes the thought of using alcohol or drugs as a question. In reconsideration what primarily begins as a choice ends in the eternal disease of addiction. A disease by definition is any condition that causes extreme pain, dysfunction, distress, social problems, and/or death to the person stricken.

Addiction without question falls under this category of mental illness. Risk Factors Researcher, Harold Johnson, (2004) states that risk factors for substance abuse includes, individual susceptibility i. e. genetic, psychiatric condition and stress. , or environmental factors like drug availability, peer pressure, conditioning, settings, and drug effects such as, addictiveness, drug purity, frequency, Moreover, Johnson

(2004) reports that the prolonged use of substances begin molecular changes in the signaling properties of neurons.

Chronic substance use produces three types of changes that may take place in the brain centers that control somatic functions, rewards and pleasures, and expressive memories. That is important to point out because it could explain why some individuals may not be able to quit abusing drugs and /or alcohol. Effects of Addiction The role of one’s environment is also a significant factor in the effects on the brain.

Scientists have shown, using brain imaging techniques, that environmental factors have lasting effects on brain receptors that are altered by drug use, which provides the possibility of molecular basis for the nature of relapses (Kuehn, 2005). In a study conducted by Nader and Czoty, they used animal models to search for clues of how environmental factors effect human addiction (Keuhn, 2005). The researchers studied the difference between cocaine use by lab monkeys and the stressors the subjects experienced living in a hierarchal social group. First the researchers discovered that the monkeys who were subservient were more likely than their ominant counterparts to use cocaine and in higher quantities as well.

The imaging studies showed that those effects were directly correlated with the dopamine receptor levels in the subject’s brain. Therefore, the researchers stated that the more dominant monkeys appeared to develop more dopamine receptors while the subordinate monkeys maintained the same number of dopamine receptors as in baseline. Also, the researchers found that while the monkeys abused cocaine both groups lost dopamine receptors and once they remained sober for many months, only the dominant monkeys showed

a rebound in the numbers of dopamine receptors (Keuhn, 2005).

This information is helpful to a social worker because it can help to explain the need for proper treatment for clients with drug abuse issues. If the client feels as if he/she is subservient, then those feelings may paralyze rehabilitation. Theories Pertaining to Substance Use There are many different kinds of addictions, from drugs to interpersonal relationships. Although these diverse addictions vary in many ways there are common threads that bind them together. There are several theories that model addiction: genetic theories, exposure theories (both biological and conditioning), and adaptation theories.

To be successful, an addiction model must blend the multidimensional aspects of addiction. It must account for cultural difference, relational preferences as well hold true for the range of addictions. Lastly, theories must be able to describe addiction as it occurs through human experience. Although animal studies can support in understanding behavior, results need to be carefully interpreted before they are applied to the much more intricate nature of a human being. Genetic Theory The genetic theory of addiction, known as addictive heritage, attempts to separate the genetic and environmental factors of addictive behavior.

Studies have been done to control for environmental components to determine if genetics plays a greater role. Most studies looking at alcoholism have determined that children born from alcoholic parents who are adopted into non-alcoholic families have a doubling increase in the rate of alcoholism over the rest of the population. Indeed, children born and raised by alcoholic parents have an even greater rate of alcoholism. This suggests that there is some genetic predisposition to alcoholic addiction

(Johnson, 2004). Adaptation Theory

The adaptation theory includes the psychological, environmental and social factors that impact addiction. Supporters of these theories have analyzed how anticipations and opinions about what a drug will do for the user and how it will influence the behavior associated with its use. They identify that any number of factors, including internal and external signs, as well as individual emotional experiences, will contribute to addictive potential. They support the views that addiction involves cognitive and emotional directive to which past conditioning contributes.

Researchers have noted that drug users rely on drugs to adapt to inner necessities and outer stresses. The research has focused on the psychodynamics of drug dependence. Behavioral and Cognitive Theory The behavioral/cognitive and the sociocultural views are seen throughout poor communities, as well as middle-class communities that may be experiencing stress from jobs and the economic situation. In sociocultural therapies, community prevention programs, and self -help programs, are all common ways for treatment.

In all treatment practices, social group therapies are used. Alcoholics Anonymous and Narcotics Anonymous are just two examples of a social group therapy. Relapse prevention therapy and behavioral control are used in Behavioral/Cognitive therapy. Biological therapy treatments use detoxification, antagonistic drugs and maintenance therapy. CBT is based on a combination of Behavioral Theory and Cognitive Theory. Researcher, Lee Black reports, “Both cognitive and behavioral theories have led to interventions that have been proven effective in treating substance abuse. Behavioral therapies are based on theories of classical conditioning, operant conditioning and social learning.

Classical conditioning goes back to Pavlov’s famous experiments with dogs. It is explained by paring of unconditioned stimuli with

conditioned stimuli until the organism learns to respond to the conditioned stimuli” (Black & Bruce, 1989). Operant conditioning holds that behavior is a function of its consequences and can be altered by the use of reinforcement and punishment (Black & Bruce, 1989). Modeling is the most prominent behavioral treatment founded on social learning theory” which emphasizes that subjects may learn a behavioral repertoire through observation of others (Black & Bruce, 1989). Social Problems and Social Justice Drug addiction is a big challenge for the society. Addicts do not comply with societal norms and values and act only to fulfill their own interests. Drug addiction is some cases can lead to HIV and / or Hepatitis C infection. However, an individual does not always become a drug addict all by himself or herself. Many societal processes facilitate this.

We can examine the issue of drug trafficking to understand how larger processes in society influence individuals. After the 1980s, though the Gross National Product (GNP) in our country grew, yet due to unfair income distribution the work force and other marginalized sections became more disadvantaged. Their negotiating power got restricted and the unorganized sector grew in primary manufacturing, construction, trade and commerce, transport, storage and communication sectors. Rapid rise-in unemployment and growth of slums in urban centers have led unemployed youth to using drugs (Chambers, et al 2005).

Implications for Social Worker Practice Social workers are often the “first service providers to have contact with substance abusers through the major service delivery systems such as child welfare, family service, employee assistance, schools, programs for the elderly” and community mental health centers (Hall, Amodeo, Shaffer, &

Bilt, 2000, p. 142). Hall, et al. found that social workers had “significantly higher levels of knowledge and skill in seven of twelve treatment areas investigated” (p. 151).

Areas where social workers were lacking in skill and knowledge were use of specific screening instruments, brief treatment techniques, motivational interviewing techniques and manual-guided treatment. Of concern is that CBT, and the 12-Step Facilitation require brief treatment techniques. Motivational interviewing techniques are used in substance abuse treatment. Twelve-Step Facilitation is a “manual-driven treatment approach workers need more training to overcome deficits in these important areas. (NIDA, 2000) Social workers and students need more training generally in the field of substance abuse nd in the specific therapeutic models used in substance abuse agencies (Hall, Amodeo, Shaffer, & Bilt, 2000). Though social workers have the highest level of knowledge and skill in many substance abuse agencies, it is important not to rest there. Social workers encounter substance abusers and need the skills to recognize and deal with the problem when the opportunity presents itself. There is also a need for more training in the specific treatment models such as CBT and other models discussed above. Conclusion

This writer feels that many therapists miss a very important aspect of recovery. Too often the only goal is abstinence and the client is not encouraged to commit to a long-term program of recovery. This may deny the client an opportunity to gain a more fulfilling and purposeful life in addition to remaining drug and alcohol free. If a therapist or social worker is not well trained in substance abuse or has no experience with addicts and alcoholics who have achieved

sustained sobriety through the 12-steps, the therapist may not understand how much clients can gain from these programs.

In 12-step circles, achieving abstinence without a life changing program or event is referred to as a “dry-drunk” meaning the person may still live the same unhappy existence though not using alcohol or drugs. Social work is a profession which promotes social change and problem solving in human relationships and the empowerment and liberation of people to enhance wellbeing. Utilizing theories of human behavior and social systems, social work intervenes at the point where people interact with their environments. Principles of human rights and social justice are fundamental to social work.

Social work is recognized as a specialist profession with a sustainable universal value, expertise and knowledge foundation. Cognitive-behavioral therapy gives social workers and therapists another tool to effectively help a large number of clients. CBT is proven effective in a broad range of settings with a wide range of clients. In this writer’s opinion and experience, however, it usually does not replace the support, spiritual growth, and social aspects of 12-step programs. To clients for whom 12-step programs work, they can become the foundation for a whole new fulfilling life not just a means of survival.