Discussion: Legal and Ethical Concerns

NOW F OR AN ORIGINAL PAPER ASSIGNMENT:Discussion: Legal and Ethical Concerns

Legal and Ethical Concerns

U.S. policy based on prohibition and criminal sanctions against use and sale of illicit drugs

Criminal activities (violence and drug trafficking)

Drinking and driving, working while intoxicated

Impact on fetus (FAS)

Modes of intervention

Limit access

Media campaigns

Educational programs

National organizations that promote community education, research, and support

26Prevention Strategies

Primary prevention

Needs assessment to identify high-risk situations and potential problems

Decriminalization and legalization of drugs(?)

Community-based programs

Training of health professionals

Faith-based initiatives

Volunteer consumer groups

Organized sports programs

Employer programs

Often overshadowed by “War on Drugs”

27Prevention Strategies (Cont.)

Secondary prevention

Screening and finding resources

CAGE: an alcoholism screening test

Clinical Institute Withdrawal Assessment (CIWA)

Use evidence-based programs

Efforts should be specific to aggregates, rather than directed at the “general public”

Incorporate culturally sensitive and appropriate interventions and strategies

Work toward improving individuals’ general competencies, communication skills, and self-esteem

28Treatment

For individuals, consider:

Cultural and educational background

Resources of the person

Attitudes of significant others

Degree of invasiveness of the effects of the substance use The existence of alternatives

Relapse prevention

29Treatment (Cont.)

Inpatient and outpatient treatment programs

May or may not include detoxification component

Voluntary vs. compulsory

Pharmacologically based vs. drug free

Treatment approaches and models vary

Assessment process is of primary importance.

Therapeutic relationship based on trust is essential.

Physical examination is a valuable tool.

Nonjudgmental attitude minimizes defensiveness.

30Treatment (Cont.)

Programs usually include:

Group and individual therapy and counseling

Motivational interviewing

Family counseling

Education

Socialization into 12-step mutual self-help groups

Integrate psychotherapy with pharmacotherapy

May include other strategies:

Hypnosis, occupational therapy, confrontation, assertiveness training, blood alcohol level discrimination training, behavior modification approaches

31Treatment (Cont.)

Pharmacotherapies

Used in detoxification, stabilization, maintenance, as antagonists, and as treatment for coexisting disorders

Mutual help groups

Operate through face-to-face supportive interaction focusing on a mutual goal; AA was first

Harm reduction

Elimination of the more harmful effects of substance use through behavior and policy modifications