DRUGS, ALCOHOL, AND TOBACCO: LEARNING ABOUT ADDICTIVE BEHAVIOR

By B. CASIS

CONTENTS CHAPTER 1 THE OPIOID EPIDEMIC SUD FACTS FIGURES AND ASSESSMENT TOOLS 1 CHAPTER 2 THE NEUROBIOLOGY OF OPIOID DRUG ADDICTION 33 CHAPTER 3 PHARMACOLOGIC CONCEPTS IN OPIOID ADDICTION TREATMENT THROUGH THE CONTINUUM 45 CHAPTER 4 MATERNAL SUBSTANCE USE SYSTEMICALLY UNDERSTANDING TREATMENT AND RECOVERY 67 CHAPTER 5 OPIATE HEROIN USE IN PREGNANCY 103 CHAPTER 6 COMPLEMENTARY AND INTEGRATIVE THERAPIES FOR THE TREATMENT OF OPIOID ABUSE DISORDER 117 CHAPTER 7 ADOLESCENT SUBSTANCE USE 149 CHAPTER 8 COUPLE AND FAMILY THERAPY BEST PRACTICES IN SUBSTANCE USE DISORDERS 171 CHAPTER 9 UNDERSTANDING THE INTERSECTION BETWEEN TRAUMA AND SUBSTANCE USE TREATMENT RECOMMENDATIONS 201 CHAPTER 10 DRUG TREATMENT COURTS 217 CONCLUSION 241 CHAPTER 1 THE OPIOID EPIDEMIC SUD FACTS FIGURES AND ASSESSMENT TOOLS ABSTRACT THIS CHAPTER DISCUSSES THE HISTORY AND ALSO PROVIDES FACTS AND FIGURES ON THE OPIOID EPIDEMIC CURRENTLY AFFECTING THE USA IN ADDITION TO VARIOUS GRAPHS THAT TRACKS AND TRENDS THE EPIDEMIOLOGY OF THE EPIDEMIC THE SECOND PART OF THE CHAPTER DISPLAYS THE VARIOUS ASSESSMENT TOOLS FOR SUBSTANCE USE DISORDERS AS MANY INDIVIDUALS HAVE CO DEPENDENCIES THESE ASSESSMENT TOOLS ARE NOT ONLY TOOLS FOR ASSESSING OPIOIDS BUT ALSO OTHER SUBSTANCES ACCORDING TO THE CENTERS FOR DISEASE CONTROL CDC OVER 700 000 PEOPLE HAVE DIED FROM A DRUG OVER DOSE BETWEEN THE YEARS OF 1999 TO 2017 1 APPROXIMATELY 68 OF OVER 70 200 DRUG OVERDOSES IN 2017 RESULTS FROM AN OPIOID DEATHS INVOLVING OPIOIDS WAS 6 TIMES HIGHER COMPARING 2017 TO 1999 SUCH OPIOID DEATHS RESULTS FROM PRESCRIPTION OPIOIDS HEROIN AND ILLICITLY MANUFACTURED FENTANYL WHICH IS NOW A LEADING CAUSE OF OVERDOSE IN THE UNITED STATES ON AVERAGE AT LEAST 130 AMERICANS OR MORE DIE EACH DAY IN THE UNITED STATES FROM AN OPIOID OVERDOSE CDC 2019 CDC NATIONAL CENTER FOR HEALTH STATISTICS 2017 CDC OUTLINES 3 WAVES THAT HAVE CONTRIBUTED TO THE RISE IN OPIOID OVERDOSE DEATHS WAVE 1 INCREASED PRESCRIBING OF OPIOIDS THAT BEGAN IN THE 1990S WAVE 2 A RAPID INCREASE IN OPIOID OVERDOSE DEATHS SECONDARY TO HEROIN STARTING IN 2010 WAVE 3 AN INCREASED NUMBER OF OVERDOSE DEATHS SECONDARY TO SYNTHETIC OPIOIDS MOST NOTABLY ILLICITLY MANUFACTURED FENTANYL TODAY MUCH OF THE HEROIN COUNTERFEIT PILLS AND EVEN COCAINE CONTAIN FENTANYL 1 2 3 FIGURE1 DISPLAYS THESE 3 WAVES FIGURE 1 3 WAVES IN THE RISE IN OPIOD OVERDOSE DEATHS DEATHS PER 100 000POPULATION DRUGS ALCOHOL AND TOBACCO LEARNING ABOUT ADDICTIVE BEHAVIOR 2 FIGURE 2 DEMONSTRATES THAT 130 OR MORE AMERICANS DIE EACH DAY FROM OPIOID OVERDOSE FIGURE 2 130 OR MORE AMERICANS DIE EACH DAY FROM OPIOID OVERDOSE THERE ARE FOUR PRIMARY FACTORS THAT HAVE CONTRIBUTED TO THE DEVELOPMENT OF THIS EPIDEMIC THE FOUR MAJOR CONTRIBUTING FACTORS ARE THE FOLLOWING 1 PHARMACEUTICAL COMPANIES 2 ACCREDITATION STANDARDS 3 PROVIDERS 4 PATIENTS LET US DISCUSS EACH OF THESE FACTORS PHARMACEUTICAL COMPANIES DEVELOPED THE FIRST OPIOIDS THAT WERE USED FOR PAIN MANAGEMENT IN THE UNITED STATES IT SOON BECAME A BILLION DOLLAR INDUSTRY THERE WERE NO INCENTIVES FOR PHARMACEUTICAL COMPANIES NOT TO DEVELOP MORE OPIOIDS FOR PAIN CONTROL IN 1995 PAIN WAS IDENTIFIED AS THE FIFTH VITAL SIGN IN 2001 THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE OGANIZATIONS DEVELOPED STANDARDS FOR PAIN AS A QUALITY INDICATOR THE AMERICAN ACADEMY OF MEDICINE MOST COMMONLY KNOWN AS THE INSTITUTE OF DRUGS ALCOHOL AND TOBACCO LEARNING ABOUT ADDICTIVE BEHAVIOR 3