Category: Addiction

A book titled Addicts who survived: An oral history of Narcotic Use in America before 1965 by David Courtwright et al. is a history of the American addiction to narcotics problem and anti-drug policies. The value of this work is in the approach that the authors took to uncover the truth  they combined historical facts with personal narratives of people who had an addiction and survived. The authors highlight how varied factors, mainly race, persons background and social status in combination with the flawed justice system contributed to the development of the drug addiction problem in the United States. The book by Courtwright et al. helps the reader understand the flaws of the past and current policies and the roots of this problem that can be traced back to the 1920s.

In recent years, the United States were affected by the opioid crisis since many of the states citizens became addicted after they were prescribed with these medications. In this light, Courtwrights book is of even more value for the historians, policymakers, and the wider society, since it addresses many myths about drug use. For example, this book debunks the idea that opioids taken under medical supervision cannot make one develop a drug addiction. Back in 1906, doctors overprescribed narcotics and manufacturers of medications put narcotics into their drugs without informing the patients of this on the label of the product (2). Therefore, a parallel can be drawn between the modern-day opioid crisis and the one in the past, since in both cases patients did not understand the potential consequences of them taking opioids.

The social status and the attitudes of people towards addicts and minorities played a role in stigmatising drug abuse. Between the 1920s and 1960s, the common belief was that drug addicts are to blame for their addiction. Courtwright et al. describe the policies of that time as unprecedentedly strict and punitive (10). Thus, the laws were developed with the belief that individuals should be punished for their inability to overcome their bad habits.

As Courtwright et al. progress in explaining the governments policies implemented to address the problem, it becomes apparent that the strategy was targeting the addicts and not their addiction. Moreover, ones race and social status intensified the problem since data shows that minorities are treated prejudicially and are sent to prison or institutions for addicts (Courtwright et al., 20). Therefore, the societal attitudes contribute to widespread drug abuse.

The improper justice system contributed to the developing issue of narcotics use. Courtwright et al. use personal stories of former addicts to illustrate how their drug abuse became worse after they were sent to prison. Courtwright et al. collected evidence from former drug addicts, in total, the book has over 30 stories from individuals who faced the drug addiction problem (xv). In one of these stories, Sophia, a prostitute who became addicted to drugs, was sentenced to five years in prison. After five years, when she was released from jail, she was still an addict, although the purpose of her sentencing is to help her overcome the addiction. Therefore, the justice system contributed to the intensification of the drug abuse problem.

Overall, the book Addicts who survived: An oral history of Narcotic Use in America before 1965 by Courtwright et al. helps understand the premise of the drug abuse problem in the states. The authors consider the policies that were in place in the 1920s and 1960s and the approach of blaming the addicts instead of helping them. The stories of addicts, such as Sophia, help understand that prison sentencing does not help overcome drug addiction.

Work Cited

Courtwright, David T., et al. Addicts Who Survived: An Oral History of Narcotic Use in America before 1965. University of Tennessee Press, 2013.

How an Understanding of Trauma Informs the Development of the Interventions

Most soldiers suffer from Post Traumatic Stress Disorder (PTSD) due to the exposure to traumatic incidences during the course of dispensing their mandate. Studies have established a great connection between PTSD and addiction. This assertion holds because most soldiers struggling with addiction also exhibit signs of PTSD. According to recent statistics from the Department of Veteran Affairs, about 2 out of 10 retired soldiers suffering from PTSD also struggle with alcoholism, hence an indicator that substance abuse among the veterans is closely linked to trauma (Volkow, 2011). In addition, the statistics indicate that 1 out of 3 veterans seeking treatment for substance abuse also suffer from PSTD.

Nurses and other medical staff engaged in the provision of medical treatment for veterans are well versed with the stressful situations that veterans go through (Potenza, 2008). Research indicates that treatment is more effective when both PTSD and drug addiction interventions are run concurrently than dealing with each problem at a time. Guided by research findings by different scholars, nurses in the Department of Veterans have thus adopted treatment methods that facilitate dealing with both problems simultaneously in a bid to ensure that the desired results are achieved (Seal et al., 2012).

In the veterans department, care is afforded in stages after the recognition that the two problems cannot be eradicated in the short term. Therefore, long-term intervention measures are needed due to the trauma, which is evident amongst the veterans. However, in some cases, the emphasis is laid on the causes of addiction as opposed to the problem of addiction itself. In such cases, nurses concentrate on treatment based on the common PTSD symptoms.

The Neurobiological Processes and Behavior Consequences of Addiction

The neurobiology of addiction involves more than the neurochemistry of reward (Seal et al., 2012, p. 946). The frontal cortex of the mind and the primary white matter linkages between the frontal cortex and circuits of reward, motivation, and memory are fundamental in the materializations of deformed impulse control, altered judgment, and the dysfunctional pursuit of rewards, which appears as a desire by the affected individual to look normal (Seal et al. 2012, p. 946).

The frontal lobes are imperative in hindering impulsivity and helping human beings to delay indulgence aptly. In cases where individuals suffering from addiction exhibit problems in controlling their gratification, there is a neurological locus of these problems in the frontal cortex (Potenza, 2008, p. 3185). Research indicates that the frontal lobe morphology, connectivity, and functioning continue to grow in ones lifetime and thus exposure to drug and substance abuse harms or deters growth, which causes adverse effects on the behavior of the affected individual. Early exposure to drugs and other substances may have severe consequences on the development of the frontal lobe morphology, connectivity, and functioning, and thus it increases the risk of addiction (Potenza, 2008, p. 3185).

Addiction causes great impairment in the functioning of the brain since it attacks some sections of the brain slowly, thus causing problems in perception, wisdom, impulse control, compulsivity, and judgment. Persons struggling with addiction are often reluctant to calls for change in behavior. In addition, alcohol and drug abusers exhibit a perceptible lack of pleasure of the enormity of cumulative dilemmas and complications

The Bio-Psycho-Social-Spiritual Impact of Addiction on Individuals, Families, and Society

Psychosocial development is a continuous development process that occurs in ones lifetime (Glasner-Edwards & Rawson, 2010). However, the development may be altered by certain factors, which include stress, addiction, and exposure to traumatic incidences among others. However, addiction is the most notable cause of retarded psychosocial development. Most people suffering from addiction are prone to the problem of addiction.

Persons with addiction problems tend to avoid intimate relations and they often prefer living alone (Miller, Sorensen, Selzer & Brigham, 2006). This aspect could be used to explain the reason why most veterans are divorced and they have tendencies of engaging in harmful activities such as unprotected sex. Addiction leads to low self-esteem among the drug users, and in most cases, they tend to live in isolated places to avoid mixing with other members of society. Since the addiction problem among veterans is connected to stress and trauma, the effects on their mental health cannot be overlooked.

The Cultural Factors that Affect Assessment and Interventions of Addiction

Despite the established guidelines for healthcare provision requirements for nurses and other medical staff, the issue of culture and religion must be considered while meeting the health care needs for patients in a clinical setting (Potenza, 2008). Cultural beliefs vary from one individual to another and certain forms of treatment may not be accorded to some patients due to socio-cultural inhibitions. Therefore, nurses must be careful when recommending certain types of treatment to addiction patients. Apparently, what may seem fit to the healthcare provider may be prohibited culturally to the patient.

One of the cultural barriers to treatment of addiction is the belief by certain communities on non-disclosure of personal information to medical staff. This barrier is most notable amongst American immigrants who believe in non-disclosure of information concerning their personal lives. Given that addiction treatment involves counseling; such individuals will be reluctant in disclosing their addiction status to healthcare providers, thus delaying health care provision or preventing it all together (Petrakis, Rosenheck & Desai, 2011).

Stigma is another cultural factor that greatly affects treatment of addiction and it is common in the Asian communities living in America (Miller et al., 2006). People suffering from addiction are prone to stigmatization from other members of the community, which leads to their reluctance in seeking medical attention from healthcare professionals. Moreover, some communities believe in other forms of medication and they rarely rely on the modern medication for treatment (Seal et al., 2012). Therefore, it becomes hard for nurses to administer treatment to such groups.

The Most Current Evidenced Based Practice for Addiction Treatment

Opioid Addiction

Methadone is one of the most recognized drugs for the treatment of problems related to opioid addiction as it produces the desired results when combined with behavioral therapy (Volkow, 2011). Opioids are meant to relieve pain, but currently, they are commonly used amongst persons suffering from PTSD. The administration of methadone blocks the impacts of illicit opioids coupled with reducing cravings for the drug among its users. It is highly effective when combined with behavioral therapy such as group counseling. Naltrexone is another effective drug in the treatment of opioid-related addictions. Just like methadone, naltrexone has been in use for a long time in the US (Glasner-Edwards & Rawson, 2010). Naltrexone reverses the effects of opioids and the treatment is based on the principle that the absence of the desired feeling within an addict will compel him/her to quit the abuse.

Alcohol Addiction

Opioid abuse has been identified as one of the leading causes for craving alcohol among its users (Potenza, 2008). Given that Naltrexone reverses the effects of opioids, it is an effective medication for the treatment of alcoholism prompted by opioid addiction.

Acamprosate

Acamprosate is another important treatment method that has been approved by the Centre for Disease and Control (CDC) for the treatment of alcoholism (Fontana & Rosenheck, 2008). The drug reduces the symptoms associated with the sudden withdrawal from alcoholism. Other medications that have been tested and recommended for treatment of alcoholism include Disulfiram and Topiramate (Volkow, 2011). Disulfiram is used to induce undesirable reactions such as nausea, vomiting, and palpitations upon intake of alcohol by the abuser. The above treatments produce good results when integrated with behavioral therapy. Behavioral therapy imparts skills to the patient that enables him/her to fight addiction effectively with the help of medication.

Cognitive-Behavioral Therapy (CBT)

CBT is combined with other medications in order to produce the desired results in the treatment of addiction to alcohol, cocaine, and other substances (Petrakis et al., 2011). CBT involves imparting coping skills to the victims of addiction, which include skills to identify the positive and negative consequences of substance abuse coupled with self-monitoring skills meant to empower client to identify cravings in early stages and developing the requisite skills to avert it (Potenza, 2008). Research indicates that the skills acquired by the recipients remain viable even after quitting the behavior.

Motivational Incentives Method

This method of treatment involves the use of incentives to cause behavior change among drug addicts exhibiting undesirable behaviors due to addiction (Volkow, 2011). The method has worked effectively in reducing addiction to marijuana, alcohol, tobacco, and opioids among other popular drugs. Studies conducted to determine the effectiveness of the treatment reveal that the method is successful in motivating drug abusers to accept medication coupled with promoting abstinence.

Community Reinforcement Approach Plus Vouchers

This approach involves a 24-week intervention plan and it targets persons suffering from cocaine and alcohol addictions (Glasner-Edwards & Rawson, 2010). The therapy is integrated with material gifts in the form of vouchers to cause behavior change amongst the patients. The treatment aims at achieving abstinence through incentives aimed at maintaining the abstinence state amongst the patients.

The Legal and Ethical Issues Inherent in the Model of Practice in the Field of Addiction

In providing treatment to veterans involved in alcoholism and drug abuse, nurses and other medical staff are locked in ethical dilemmas. Some of the issues that are inherent in the field of addiction include

Justice

The medical code of ethics requires all patients be afforded equal treatment irrespective of age, gender, or status (Fontana & Rosenheck, 2008). In affording care for the veterans, personal prejudices ought to be shelved in a bid to achieve effective and fair treatment to all in accordance with the principle of justice. Given that drug addiction interventions involve persons with impaired judgment, the principle may present controversies in individual cases depending on the attention required by the client. Nurses taking care of the veterans need to understand the principle of counter-transference, which denotes the conscious reactions to the clients demands. Drug addicts may be stubborn, thus prompting nurses to respond negatively to their demands.

Beneficence

This principle requires healthcare providers to act in a manner that maximizes the benefits accruing to the patient and minimize the chances of harm (Volkow, 2011). In taking care of alcoholic individuals, care must be taken concerning their culture and social norms since they may not be congruent with what the nurses see as good (Seal et al., 2012). In other words, some actions may be executed in good faith, but they may contradict the clients religious and cultural beliefs.

Boundaries

The issue of boundaries is another source of controversy in treatment against alcoholism and substance abuse (Potenza, 2008). The principle of boundaries requires that healthcare providers to cease from engaging in boundary violations such as engaging in an intimate relation with the client, acquiring personal gains, or other gestures that may be misinterpreted (Miller et al., 2006). However, some scholars have tried to draw a line between beneficial and harmful boundaries by claiming that relations meant for the benefit of the client are justified, since they produce the desired results.

Confidentiality

The principle of confidentiality requires the privacy of the clients information to be maintained at all cost (Glasner-Edwards & Rawson, 2010). However in some cases, this principle is compromised due to the use IT system to store data as such records are accessible to other staff members. Court orders requiring the disclosure of confidential information regarding the client may also undermine the principle of confidentiality (Fontana & Rosenheck, 2008). However, through consultation with their supervisors, nurses may provide only the relevant data required in a particular case.

Informed Consent

This aspect is another controversial principle that requires healthcare providers to disclose all material facts regarding the treatment to be afforded to patients before obtaining their consent (Petrakis et al., 2011). However, this requirement is undermined by the fact that persons suffering from addiction are not in a position to make viable judgments. However, nurses must disclose all the facts regarding the treatment and notify the clients of their rights before obtaining written consent.

References

Fontana, A., & Rosenheck, R. (2008). Treatment-seeking veterans of Iraq and Afghanistan: Comparison with veterans of previous wars. The Journal of Nervous and Mental Diseases, 196(7), 513-521. Web.

Glasner-Edwards, S., & Rawson, R. (2010). Evidence-based practices in addiction treatment: Review and recommendations for public policy. Health Policy, 97(2), 93-104. Web.

Miller, R., Sorensen, L., Selzer, A., & Brigham, G. (2006). Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. Journal of Substance Abuse Treatment, 31(1), 25-39. Web.

Miller, R., Zweben, J., & Johnson, R. (2005). Evidence-based treatment: Why, what, where, when, and how. Journal of Substance Abuse Treatment, 29(4), 267-276. Web.

Petrakis, L., Rosenheck, R., & Desai, R. (2011). Substance use comorbidity among veterans with posttraumatic stress disorder and other psychiatric illness. The American Journal on Addictions, 20(3), 185-189. Web.

Potenza, M. (2008). The neurobiology of pathological gambling and drug addiction: an overview and new findings. Philosophical Transactions, 363(1507), 3181-89. Web.

Seal, H., Shi, Y., Cohen, G., Cohen, E., Maguen, S., Krebs, E., & Neylan, T. (2012). Association of mental health disorders with prescription opioids and high-risk opioid use in US veterans of Iraq and Afghanistan. JAMA, 307(9), 940-947. Web.

Volkow, N. (2011). Principles of Drug Addiction Treatment: A Research-Based Guide. Darby, PA: DIANE Publishing. Web.

Goeders & Guerin (1994) point out that anxiety and stress may be involved in drug use and increased risk of dependency, as these are involved in the etiology of cocaine use. This is also supported by Carlson & Birkett (2021), describing a study where stressed rats became more sensitive to the effects of cocaine. Other evidence suggests that the earlier the stress, the greater the impact of long-lasting drug-taking behavior. Therefore, other factors contributing to stress, such as isolation, anxiety, and pain are evident factors. Furthermore, some elements of brain activity, such as a lower media prefrontal cortex function, are present in drug users.

Conflict experiments have been used since the mid-20th century to mimic human behavior in animals. Essentially for one component, a shock was delivered, while nothing was done for the other, creating a control group type of situation. This conflict paradigm is meant to create a stress-like response in animals that humans would face in order to devise a reliable methodology for screening for anxiolytic drug activity. Once the shocks were administered, it would create behavior change in the animals, and the drug was administered to determine if changes out occur (Goeders & Guerin, 1994).

Goeders and Guerin (1994) designed the experiment to test the effect of both predictable and unpredictable stress. The shock contingent first group of rats received a shock every time they pressed a lever for food, reinforced during the first part of the experiment. Meanwhile, the shock non-contingent rats in the second group would receive the shock as well upon the first group pressing the lever. However, unlike the first group, their shock was not related to food nor initiated by their actions, so it was essentially random. This created the so-called conflict paradigm and a high-stress situation. Since the rats were then given the option to self-administer cocaine at varying doses, the goal was to identify whether the contingency changed the behavior of rats in terms of substance abuse. Carlson & Birkett (2021) highlight that reinforcement plays a direct role in substance abuse, as both positive and negative reinforcement contributes to its development. The reinforcement of stimulus occurs immediately after a response, which is why many drug users prefer not necessarily more potent drugs but ones that work quickly. Negative reinforcement is a behavior that reduces an aversive stimulus will also be reinforced. Therefore, when the rats were randomly shocked, without the prior stimuli of food, they likely experienced some level of pain, and were offered cocaine. The cocaine masked the pain and stimulated pleasure centers, reducing the aversive stimulus and generating addiction.

The results of Goeders & Guerin (1994) determined that the rats in the non-contingent independent foot shock group self-administered the largest amount of cocaine. The acquired cocaine in low doses but high frequency before maxing out. The contingent group was second in self-administration, while the third control no shocks group was also the lowest in self-administration. Given the set-up of the experiment, it seems the no-shock group was meant to recreate a no-stress control environment, one where no stimulation was applied to the rats. The study premise was that some individuals could use cocaine recreationally, without addiction, while others see escalating patterns of use, whereas, like in the non-contingent group, the amount no longer mattered as long as a dose could be attained. Stress-induced environment and anxiety are variables that potentially influence the behavioral and neurobiological variables responsible for this control. Therefore, the potential outcome is whenever an individual is more susceptible to stress, the greater the possibility of addiction.

References

Carlson, N.R., & Birkett, M. (2021). Foundations of behavioral neuroscience (10th ed.). Pearson.

Goeders, N. E., & Guerin, G. F. (1994). Non-contingent electric footshock facilitates the acquisition of intravenous cocaine self-administration in rats. Psychopharmacology, 114(1), 6370. Web.

According to the Planned Change Process, the first step is recognizing that change is necessary. Carlos Ramirez, a social worker at a high school in a midwestern state, should work with four teenagers who were suspended for two weeks for drinking alcoholic beverages at school. He realizes that appropriate actions and responsive measures should be developed and implemented as alcohol consumption among adolescents has already become a serious and common issue that should be addressed (CDC, 2020). The major goal of implemented changes is to reduce drinking in schools. Carlos Ramirez decided to be a change agent. In other words, he will take a responsibility for improvement from his side as even the smallest positive changes may contribute to the whole situation.

After a thorough examination of the four teenagers backgrounds and atmosphere in the school on the basis of interaction between classmates, Mr. Ramirez concluded that young people have a lack of interests and certain problems related to family relations. In addition, alcohol consumption was common in the families of two students from those four who were suspended. As a result, a social worker decided to organize scheduled meetings that will be divided into three types  meetings with parents, individual meetings, and meetings with whole classes. The main purpose of these meetings will be to provide psychological support to students, explain to them and their parents the negative impact of alcohol consumption, and provide essential tips for parents concerning how to talk about alcohol with their children. In addition, Mr. Ramirez hopes that during these meetings when adolescents are sincere and open with him, he will help students understand what interests they have, including sports activities, hobbies, and part-time jobs.

Reference

CDC. (2020). Underage drinking. Web.

Haroutunian, H. (2016). Not as prescribed: Recognizing and facing alcohol and drug misuse in older adults. Simon and Schuster.

The book in question dwells upon substance misuse in older adults and ways to address this problem. Chapter 2 provides valuable insights into the peculiarities of this populations addiction development with the focus on age and family. The author describes some of the most common reasons for and mechanisms of the development of addictions in the target population. Haroutunian (2016) also sheds light on several important training techniques that can be instrumental in implementing effective 12-Step programs. One of the central points to consider is methods to avoid ageism. Haroutunian (2016) emphasizes that people trying to help a person with addiction (including family members, counselors, and other mental health practitioners) are prone to this issue. When choosing methods to help their loved ones, these individuals ground their effort on their assumptions and knowledge about aging, which can be harmful (Haroutunian, 2016). First, it is essential to learn more about aging, and it is critical to consider all possible causes of addiction and diverse aspects to build on when developing coping strategies.

This source is valuable for the present project as I will improve my knowledge about the peculiarities of aging and the development of addiction in older adults. I will also be cautious to avoid ageism that can lead to negative consequences. When working with the client, I will also pass this knowledge to the woman who might have a limited understanding of the processes that are taking place. This awareness of potential causes of the problem and healthy ways to age can help the client overcome her addiction. The book also provides insights into spirituality at different ages that can also be a topic of discussion.

Kelly, J. (2016). Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research. Addiction, 112(6), 929-936. Web.

The article under consideration is concerned with the spiritual nature of Alcoholics Anonymous programs and their effectiveness in different populations. Kelly (2016) highlights the differences related to age, gender, and cultural backgrounds. The author notes that females tend to respond differently to the program than men. Age differences should also be considered when implementing 12-Step programs. The researcher also stresses that the spiritual elements of the program should not be confined to religious themes and topics. With less religious people, it is essential to concentrate on such areas as the good and the bad, love, compassion, forgiveness, and others. At the same time, Kelly (2016) also states that Alcoholics Anonymous should be conducted in the communities where people live in order to maximize positive outcomes. Relapse in women is more common as compared with men, especially when treatment is short. These projects should also be continuous, as participants benefit from the involvement in lasting programs.

One of the valuable insights gained from the source is associated with the essence of spirituality. Prior to discussing spiritual aspects, it is important to discuss the exact meanings behind the concept, as seen by the client. I will discuss my clients religious beliefs to make sure the program will be successful. If the woman is religious, I will definitely try to refer to sacred texts and exact passages. I will also initiate discussions of broad concepts, but if the level of religiosity is rather low, I will focus on these elements exclusively. Kelly (2016) also mentions the healing effect of music (both religious and non-religious). I will also employ music and the discussion of its impact on the program.

Matsuzaka, S. (2018). Alcoholics Anonymous is a fellowship of people: A qualitative study. Alcoholism Treatment Quarterly, 36(2), 152-178. Web.

The present article is a valuable source for the current project as it provides insights into the challenges females abusing alcohol encounter and ways to address them. For example, Matsuzaka (2018) states that alcohol addicts have to face discrimination and stigma related to gender, ethnicity, class, age, and other factors. Although the author concentrates on LGBT participants and their experiences, the utilized methods are also effective in other groups. Stigma and discrimination have diverse negative effects on the outcomes of 12-Step programs, therefore, specific attention should be paid to these areas. Matsuzaka (2018) adds that the cultural peculiarities of clients should be considered. The researcher also adds that the involvement of a larger community is beneficial for abusers. Clients should be encouraged to increase their participation in social life, starting with deeper participation in their family-based activities.

An important argument made by the author is the need to pay specific attention to the transition to sobriety. I will support the client in her transition to sobriety that will be implemented through the focus on a set of goals. These goals will be mainly related to the family and specific real-life aspects rather than spirituality. I will also consider the cultural background of my client, which will be instrumental in exploring her spirituality and helping the women in her struggle with her addiction. I will try to make my clients more engaged in the life of the community. We will discuss various events that take place and ways to become a part of the discussed activities. Active participation can be one of the measurements of the effectiveness of the program.

Ranes, B., Johnson, R., Nelson, L., & Slaymaker, V. (2016). The role of spirituality in treatment outcomes following a residential 12-Step program. Alcoholism Treatment Quarterly, 35(1), 16-33. Web.

This source deals with the evaluation of the effectiveness of a 12-step program and its impact on participants abstinence after the completion of the project. Ranes et al. (2016) claim that spirituality is an important component of any 12-Step incentive. Importantly, the researchers note that community-based treatment is the most efficient. One of the most valuable insights the researchers provide is linked to the peculiarity of spirituality. Ranes et al. (2016) argue that spirituality is not static as it is undergoing constant changes. The authors agree with other researchers regarding the religious aspect that is not seen as central to peoples spirituality. Such basic principles as gratitude, forgiveness, love, compassion, and others can be discussed. Ranes et al. (2016) state that peoples abstinence increases and remains high even after the completion of the program if proper attention is paid to spirituality. Working in groups is regarded as the preferable format, but individual counseling can also be effective.

One of the takeaways of the present source is the need to pay specific attention to gratitude and narcissism during the program. I will utilize different tools to measure the clients narcissism and gratitude. The article includes the description and validation of the most common and effective measurements, so I will employ these tools. For instance, I will use the Hypersensitive Narcissism Scale and Narcissistic Personality Inventory 16, as well as Gratitude Questionnaire-6. I will also employ methods to reduce the former and improve the latter. As has been mentioned above, spirituality is a dynamic notion, so I will trace the changes in the clients spirituality during the program. We will pay more attention to some general topics although certain religious themes and symbols will also be discussed.

Motive for Smoking

The rapists typically advise those who are daily tobacco users to quit, despite their willingness. However, the intervention for the smokers without any desire to stop is a complicated one. It primarily consists of multiple brief motivational interviewing sessions which last for several minutes. An Intervention should be educational to create supportive environment for the smoker. During the motivational interviewing, physicians try to understand the values, ideas, worldview, and reasons for smoking tobacco (Treating tobacco use and dependence, 2008). The doctor has to find contradictions in smokers mindset and use them against the destructive habit. It is natural for the patient to have some doubts about quitting; nonetheless, the therapist uses ones professional experience and knowledge to minimize any fears. Although it is a challenge for physicians, there are successful methods to help smokers.

Counseling and Behavioral Treatment Smoking

First of all, counseling and behavioral treatment is one of the most effective practices to quit smoking. For the nicotine addicts, a cigarette is a tool to manage stress, solve various problems, and to deal with anxiety. In other words, the habit is strongly associated with a method of handling a stressful situation (Klemperer, Hughes, Solomon, Callas, & Fingar, 2017). Counseling helps to develop a problem-solving skill and stress management. New strategies for handling nervous events help patients to reduce the desire to smoke (Treating tobacco use and dependence, 2008). The smoking also might be a symptom of an unresolved mental disorder. During behavioral counseling, therapists identify the roots of the problem and resolve the internal conflict one might have.

Secondly, medication in combination with counseling has been an effective strategy to quit smoking. As a matter of fact, medication can substitute cigarettes for the first several weeks of abstinence. Patients experience nicotine withdrawal symptoms which are hard to ignore. Symptoms will affect the behavior of the patient and ones welfare. Medical treatment can replace nicotine and reduce a possibility of relapse among smokers. There are also prescribed substances which can make worse if the patient decides to smoke again. However, the state of the smoker must be monitored closely when the drugs are prescribed as it might get worse because of relapse.

Harm of Smoking for Adolescents and the Elderly

Adolescent and elderly people need special strategies to end smoking. Elderly tobacco users try to quit smoking when their health is in a poor state. It is a challenging step for them because the addiction might be several decades old. There is a high risk of relapse among elderly people too. Only behavioral therapy can help them to stop smoking and adapt to the new way of life without cigarettes. In some instances, it is easier to motivate the elderly to stop smoking because of their deteriorating health. It is an influential factor since people are afraid to worsen their quality of life. Involvement of family and friends is valuable to the success of abstinence (Treating tobacco use and dependence, 2008).

For the teenagers, however, it is important to intervene as soon as possible to prevent the formation of the addiction. Cognitive therapy has a significant impact on abstinence; it doubles chances for successful cessation. Nonetheless, teenagers require serious monitoring and continuous support, especially for the first several weeks. At the same time, it is necessary to check on the patients progress and mental struggles with addiction (Roberts, Bidwell, Colby, & Gwaltney, 2015). Due to the difficult stage of adolescence, teenagers might experience some psychological issues associated with the habit, to stabilize their mental health physicians have to communicate with them frequently.

References

Klemperer, E., Hughes, J., Solomon, L., Callas, P., & Fingar, J. (2017). Motivational, reduction, and usual care interventions for smokers who are not ready to quit: A randomized controlled trial. HHS Public Access, 112(1), 146-155. Web.

Roberts, M., Bidwell, L., Colby, S., & Gwaltney, C. (2015). With others or alone? Adolescent individual differences in the context of smoking lapses. HHS Public Access, 34(11), 1066-1075. Web.

Treating tobacco use and dependence: 2008 update. (2008). Rockville, MD: US Department of Health and Human Services.

Addiction to substances can develop as a result of several factors, and researchers have tried to explain this occurrence via different approaches. There are several theories that explain the nature of addiction and its development. The biological perspective implies that genetics and brain chemistry alterations are predisposing people to addiction. Psychological theories examine the impulsive and compulsive behaviors applicable to substance use. Sociologists look at the environment that people live in to find factors that make substance use acceptable. This paper will explain the biological, psychological, and sociological theories explanations of substance use and discuss operant conditioning as a way of comprehending this deviant behavior.

Under the biological theory, there are two primary explanations of addiction: the genetic predisposition and the changes in the brains chemistry as a result of prolonged drug administration. Hence, this theory implies that some individuals inherit a predisposition to developing a drug addiction (Cavaiola & Smith, 2020). However, Cavaiola and Smith (2020) warn that although numerous family cluster studies have shown the increased likelihood of substance abuse or dependence within a family, it is difficult to make a distinction between environmental factors and genetics. This is because families, for example, siblings or parents, typically live in the same environment and are affected by the same social factors, which may also predispose them to substance abuse. This nuance is the overlap between the social and biological theories of addiction. Regardless, evidence shows that some genetic factors play a role in the likelihood of having alcohol or substance abuse.

Another biological element that can explain the development of dependence on drugs is neuroadaptation. This theory suggests that if a person intakes drugs for prolonged periods of time, their brain chemistry changes, prompting them to intake more, which is how addiction develops (Cavaiola & Smith, 2020). Once a person intakes drugs, their brain releases dopamine and tries to mitigate the effect of this substance on them. If one seizes to use these drugs, the brains homeostasis is disturbed as it already adapted to responding to a substance as a stimulus, which causes the withdrawal symptoms. This biological concept focuses more on the issue of repeated drug use that eventually causes addiction.

Under the sociological approach, the social environment causes a person to develop substance abuse. One explanation for this may be cultural level control and peer influence (Cavaiola & Smith, 2020). The first concept suggests that different groups of people have varied standards of acceptable behavior, and for some, using drugs or abusing alcohol may be the norm. Peer influence is the effect that the behavior of others, such as colleagues, fellow students, or neighbors, has on an individual. For example, if the majority of college students on campus drink alcohol, a junior may feel alienated if they do not. Hence, they begin to use alcohol as a way of developing a connection with their peers.

The family, neighborhood, and peer environments play a role in the way a person perceives alcohol and drugs. Moreover, Cavaiola and Smith (2020) argue that other social factors, such as poverty or exposure to racism, can also affect the likelihood of an individual developing a substance addiction. The social learning theory suggests that as an individual grows, they learn the cultural norms from their environment and their perceptions of acceptable behaviors are shaped by it as well. Hence, if predisposed to unfavorable conditions, an individual may develop a substance abuse disorder.

From a psychological perspective, substance abuse may be a result of other psychological disorders. For example, impulsive or compulsive behaviors are associated with higher chances of drug dependence (Cavaiola & Smith, 2020). The implication is that people who are more likely to develop an addiction have difficulty controlling their impulses. Hence, even if they understand the issue of drug dependence and the problems associated with it, they cannot stop even if they consciously understand that a substance is harmful. Impulsive behaviors are actions that are not premeditated and undesired for an individual, which they still complete (The Farm Rehab, 2018). A common issue that people with impulsive disorders face is substance abuse. Therefore, one element of the psychological approach to addiction is the lack of impulse control.

Apart from impulsive and compulsive behaviors, psychology researchers have put forward several other theories explaining addiction. For example, the self-medication hypothesis, Self-Psychology, Attachment Theory, and Trauma theory all explain how traumatic experiences or lack of support from a caregiver shape a persons psyche in a way where addiction is acceptable (Cavaiola & Smith, 2020, p. 15). Moreover, the developments of Freud in psychoanalysis have been used to explain addiction and treat it. The underlying premise of this is that ones trauma from childhood shapes how adults cope with problems (The Department of Health, n.d.). In some cases, this trauma makes it impossible to deal with issues and results in maladaptive behaviors, such as the use of alcohol or other substances.

A theory that offers a good explanation to why individuals would choose to intake drugs is operant conditioning. This approach combines the psychological and sociological theories discussed above. Under operant conditioning, an individuals behavior is a result of them learning something and seeing the cause and effect of their actions (Horvath et al., n.d.). For example, a child seeing adults drinking alcohol may learn that this behavior is acceptable. If they begin to drink alcohol and do not face any negative consequences for it, the effect of their actions will be positive, and hence this behavior will become habitual. Alternatively, genetics may predispose one to substance abuse, and under operant conditioning, with no negative consequences, the individual will continue using drugs. Consequently, the individual will continue using drugs. Moreover, according to Horwarth et al. (n.d.), addiction is a learned behavior because the initial pleasure or enjoyment was rewarding (para. 2). Hence, if the substance in question is not pleasurable to a person in the first place, they do not face a risk of addiction. However, most substances, such as alcohol, are either manufactured to taste good or offer a rewarding experience. These rewards cause a behavior to be learned more quickly. Thus, operant conditioning helps explain how certain predispositions to substance abuse and the rewarding nature of these substances result in addiction.

In summary, this paper focuses on the different theoretical approaches to viewing racism. From a biological perspective, genetics can impact the way a person reacts to alcohol or drugs and increase their chances of developing an addiction. Next, from a social perspective, the environment where a person lives, such as their family or peers, shapes the formers attitudes towards drugs and substance abuse. Finally, the psychological theory approaches the impulsive and compulsive behaviors linked to substances. The operant conditioning concept shows how the cause and effect may shape deviant behaviors such as substance use if an individuals actions do not result in harmful consequences.

References

Cavaiola, A. A. & Smith, M. (2020). A comprehensive guide to addiction theory and counseling techniques. Routledge.

The Department of Health. (n.d.). 3.4 Models that help us understand AOD use in society. Web.

The Farm Rehab. (2018). Impulsive and compulsive behavior. Web.

Horvath, T., Kaushik, M., Epner, A., & Morgan, G. (n.d.). Operant conditioning and addiction. Gulf Blend Center. Web.

The consumption of illegal substances and the development of addiction to them remains one of the primary health-related concerns in the American healthcare setting. The problem has grown particularly noticeably among high-school students, as the recent report by the National Institute of Health (2020) has indicated. Apart from the traditional list of illicit drugs, alcohol, and smoking, the 2020 report has also included more recent trends such as vaping (National Institute of Health, 2020).

Overall, the tendency for American citizens to abuse substances appears to be growing, which is a dangerous trend that must be curbed. Due to a drop in the efficacy of the immune system performance, increased strain on essential organs such as the liver, and the high probability of developing multiple types of cancer, drug addiction represents one of the most threatening and complicated conditions, which must be prevented with the help of appropriate programs.

Notably, the effects of drug addiction vary in severity and range depending on the type of drug that an individual chooses to consume. However, most illicit substances, namely, nicotine, cannabis, and opioids, affect the brains limbic system, particularly, the part of it that defines the production of dopamine (Berman et al., 2016). As a result, drugs cause an individual to experience a state of bliss. However, as an individual continues to consume drugs, the development of a habit causes the experience of pleasure to subside and the sense of dissatisfaction increases. Consequently, one experiences a severe need to increase the drug dose, which will eventually result in overdosing (Berman et al., 2016).

In addition to the described effect, illicit substances lead to the disruption and eventual destruction of the brain communication pathways. The described effect I especially prominent in patients abusing alcohol (Ray et al., 2017). However, the continuous consumption of other substances, especially opioids, will ultimately entail the same effects (Ray et al., 2017). Namely, the process of brain damage occurs once the amount of oxygen delivered to the brain is insufficient.

Apart from the brain, other organs are also severely affected by long-term drug abuse. For example, the liver suffers significantly due to exposure to toxic metabolic products resulting from processing illicit substances (Weissman et al., 2020). For the same reason, the stomach and the pancreas are also affected very often. Furthermore, the increase in blood pressure is caused by changes in the metabolism processes, as well as shifts in mood, which drugs cause, increase exposure to heart diseases, as well as severe problems with the nervous system (Weissman et al., 2020).

The threat of cancer also increases exponentially with the rise in the levels of illicit drug use. The described outcomes are particularly common for smoking, yet other drugs may also create an environment in which the cells of different body organs may experience unchecked growth and mutate, thus creating cancerous tumors in patients (Jett et al., 2018). Therefore, the threat of cancer is not to be underestimated as one of the crucial effects of illicit drug use, either.

In people abusing illicit drugs by injecting them, infectious diseases become a highly probable threat (Medina-Perucha et al., 2019). Moreover, in the instances of long-term drug injections, a patients veins may ultimately collapse, causing severe health outcomes (Medina-Perucha et al., 2019).

Namely, the disruption of the blood flow, which the specified phenomenon entails, is likely to cause severe complications. In turn, the openness to infections, which the use of a syringe suggests, may lead to the development of STIs, as well as a multitude of other infectious diseases, which will pose a major threat to a patients health. Moreover, being infected via sharing needles may entail the contraction of HIV and AIDS, which, in turn, will most likely lead to a patients death 9). Therefore, the use of illicit drugs, particularly, opioids, will inevitably lead to fatal outcomes, even if the initial dose is minimal. Moreover, the development of lesions, sores, and other skin conditions becomes a probable outcome as a result of long-term exposure to illicit drugs.

To develop a viable solution to the issue of drug addiction among U.S. citizens, one must take the social aspect into account apart from the health-related one. Namely, the fact that an individual is likely to be coerced into continuing drug abuse by a drug dealer even after a successful intervention needs to be taken into consideration. For this reason, a program aimed at assisting people with drug misuse problems must include social protection and, particularly, the opportunity to restrict their access to a drug dealer to them.

Additionally, the problem of severe legal repercussions that one may face due to drug possession and consumption must be handled accordingly. Presently, extraordinarily severe legal implications for people possessing drugs may prevent individuals from seeking help. Therefore, it is crucial to introduce changes to the current legal system so that the emphasis should be placed on the correction of behaviors and the possibility of recovery rather than the punishment of people with drug addiction issues.

The problem of illegal drug use remains a major health issue in the United States. Affecting thousands of people, the specified concern must be handled on the level of state policies and by developing appropriate public health programs. Thus, one will be able to create an effective strategy for preventing drug abuse, as well as encourage the victims of drug misuse to address healthcare services and seek help.

References

Berman, M., Paran, D., & Elkayam, O. (2016). Cocaine-induced vasculitis. Rambam Maimonides Medical Journal, 7(4), pp. 1-12.

Cherobin, T. Z., Stefenon, L., & Wiethölter, P. (2019). Oral lesions in crack and cocaine user patients: Literature review. Oral Health and Dental Science, 3(1), 1-5.

Jett, J., Stone, E., Warren, G., & Cummings, K. M. (2018). Cannabis use, lung cancer, and related issues. Journal of Thoracic Oncology, 13(4), 480-487.

Medina-Perucha, L., Family, H., Scott, J., Chapman, S., & Dack, C. (2019). Factors associated with sexual risks and risk of STIs, HIV and other blood-borne viruses among women using heroin and other drugs: a systematic literature review. AIDS and Behavior, 23(1), 222-251.

National Institute of Health (2020). Monitoring the future study: Trends in prevalence of various drugs.

Ray, S., Biswal, B. B., Aya, A., Gohel, S., Srinagesh, A., Hanson, C., & Hanson, S. J. (2017). Modeling causal relationships among brain areas in the mesocorticolimbic system during resting-state in cocaine users utilizing a graph theoretic approach. Journal of Alcoholism and Drug Dependence, 5(4), pp. 1-8.

Weissman, S., Aziz, M., Perumpail, R. B., Mehta, T. I., Patel, R., & Tabibian, J. H. (2020). Ever-increasing diversity of drug-induced pancreatitis. World Journal of Gastroenterology, 26(22), 2902.

Adolescence is dangerous for the appearance of addictions, as it brings many difficulties for both parents and children themselves. Due to modifications in the hormonal balance, the mood changes rapidly, and the appearance becomes more adult. Teenagers try to understand the world around them and find themselves. Moreover, parents authority is no longer enough, since older children notice their imperfections and mistakes. As a result, socialization with peers, the desire to find their place in the company and keep up with others comes first. Despite the significant danger of adolescent addictions, they can be prevented through proper upbringing, motivation, and support.

Modern studies note an increase in the number of adolescents using various substances. According to research Recent surveys show the use of any illicit substances to be 15% by the time teens reach 8th grade, 28% by 10th grade, 39% by 12th grade, and 41% by the time adolescents reach college (Truong et al., 2017, p. 475). Moreover, the number of ways to use them is extending, for example, electronic cigarettes and vaporization (Truong et al., 2017). The problem is global in scope and relevant to different localities. For instance, according to Evans (2016), among nearly 7,500 people who died in Virginia from an overdose during the 2007-2015 period, most were teenagers. Experimenting with substances becomes a common part of adolescent life  smoking, alcohol, and drug use are frequent among adolescents worldwide.

Apart from substance-related dependencies, many researchers express concern about the distribution of non-substance-related disorders, including Internet addiction, dependence on video games, and others. Many factors can be a trigger for the use of various substances. The features of adolescents complicate the situation  often, their body is already quite developed, but the brain only continues to evolve. Relationships with family and friends, lifestyle, financial situation, and even simple interests can affect the decision to accept or not accept a new addiction.

As a rule, at this age, the first test of psychoactive substances occurs, as well as increased involvement in their use. Relationships with peers and family can influence the probability of addictions appearance. Dependencies, in turn, can have an impact on relationships  predominantly negative but also a positive. For example, according to a study by Savolainen et al. (2018), teens often use alcohol to get close to friends and build trusting relationships. The same study suggests that teenagers who are dependent on the Internet, often thus protect themselves from communication with their family, seeking support among the same peers online. However, this addiction, as well as drugs and gambling, can negatively affect social ties. In turn, social relations development can be a protective mechanism to help prevent the emergence of these dependencies.

The right education of a kid from early childhood, authoritative example and parents help in understanding the world around have a beneficial effect on the whole subsequent life of a person. Thus, they will be able to identify the good and bad for themselves and choose a company by interest. In their study, Lee et al. (2016) prove the positive effect of love and serving others on adolescents recovering from addictions. The results of their research can also be applied to the prevention of abuse of various substances. Serving others can contribute to the development of the right life priorities in adolescents and help them in the search for a personal place and purpose.

Thus, the problem of adolescent addiction has a serious spread. Tobacco, alcohol, drugs, as well as addictions to games and the Internet negatively affect the health of not yet sufficiently strengthened individuals. It can make a bad contribution to the entire subsequent life of the teenager. However, it is possible to prevent this problem by increasing the awareness of both children and parents. Proper education and spiritual development will help to protect adolescents against negative influences, thus enabling them to be more resistant to temptations. Future studies should aim to find and develop effective methods for educating and communicating about addictions.

References

Evans, K. B. (2016). Majority of fatal overdoses in Virginia are younger adults. Richmond Times-Dispatch. Web.

Lee, M. T., Pagano, M. E., Johnson, B. R., & Post, S. G. (2016). Love and service in adolescent addiction recovery. Alcoholism Treatment Quarterly, 34(2), 197-222.

Savolainen, I., Kaakinen, M., Sirola, A., &Oksanen, A. (2018). Addictive behaviors and psychological distress among adolescents and emerging adults: A mediating role of peer group identification. Addictive behaviors reports, 7, 75-81.

Truong, A., Moukaddam, N., Toledo, A., &Onigu-Otite, E. (2017). Addictive disorders in adolescents. Psychiatric Clinics, 40(3), 475-486.

Ethnography as a research method is, indeed, the most suitable for the study on drug use and related issues. This method has already become a classic and has established itself as the most effective in studies of closed groups (Ferguson, 2017; Turner, 2019). Moreover, the research of such phenomena is impossible using standard qualitative and quantitative methods. Therefore, the mentioned anonymous survey does not appear to be a viable method for quantifying drug addiction prevalence on campus.

On the other hand, the causal relationship model obtained as a result of the study should contain some predictions about when the found relationship will be fulfilled or not fulfilled. However, ethnography does not require an explicit formulation of theoretical predictions (although it does not exclude them). For example, such predictions about who will and who will not use drugs, or how different groups will experience withdrawal, are rarely tested. Therefore, the researcher using this method should be especially attentive to the development of theoretical predictions that are subject to verification.

Participatory observation, like other methods, faces external and internal validity problems. That is, as in the case of an experiment or sample survey, the researcher must somehow determine whether their results can be generalized and transferred to other similar groups (external validity). They must also make sure that their results are not a by-product of the observation process itself (internal validity), that is, possible sources of bias should be considered. They include historical development, maturation of respondents during the study, reactive effects, and many others.

References

Ferguson, R.-H. (2017). Offline stranger and online lurker: Methods for an ethnography of illicit transactions on the darknet. Qualitative Research, 17(6), 683698. Web.

Turner, T. (2019). Just knocking out pills: An ethnography of British drug dealers in Ibiza. Journal of Extreme Anthropology, 3(1), 102120. Web.