Drug abuse among young people is on the increase. The substances used range from legal highs such as Robistusssin, and marijuana, according to the report from the national institute on drug abuse. It continues to say that marijuana use by 8th graders has jumped to 16 percent, with the use of marijuana daily in all grades, surveyed according to monitoring the future Survey.
Analysis
This report on drug use is not far from what we discovered in research conducted among 8th graders in 5 different high schools. By the use of a simple random sampling method, the research study conducted among 350 students in 5 public schools, (70 students from each) in Little Rock focussed on students that were actively using substances like marijuana 2 weeks prior to the study itself. The students, all male, were enrolled in a 2-week simple advice anti-drug abuse counseling program in order to find out why they use drugs and also see if the program will work positively to reduce drug abuse among 8th-grade students.
The research worked on the hypothesis that the treatment would reduce or result in the total cessation of drug use, and better relations with family and friends. This would also go hand in hand with increased performance in school.
In order to answer our research questions, a semi-structured interview was developed that focuses on four primary areas:
drug listing and evaluation,
substance treatment reflections,
Social network reflections,
self-narrative reflections.
The drug listing method was based on the qualitative methodology known as ‘free listing’ by Weller and Romney. The participants are simply asked to explain on paper all the things that are part of a certain domain interest.
A student’s response, who participated in the study, was, ‘Life feels good more than before, I mean I do not depend on any drug to be happy and remain happy. He cited hopefulness due to a newfound sense of direction or control. He continued to say that, ‘I am more into my hands now than I was before, and I feel I am in control’.
When all patients were asked to describe themselves in the present, they expressed hopefulness regarding a sense of self and their lifestyles. The activity was based on the hypothesis that continual counseling can change a person’s habit of addiction. This was called cognitive behavioral therapy. They described their current selves with terminology that included, ‘smatter’, ‘happy’ and ‘motivated’. This optimism was often related to reducing drug use during the counseling program. The following is the model:
Group Level
Patients were asked to identify drugs and evaluate them as good or bad and provide an explanation for their evaluation. This was based on the hypothesis that most patients would easily identify themselves with drugs that they have been using in the past two weeks or as a habitual course. They were then put into a program that involved slowly reducing the amounts of intake per day. The process was called substance withdrawal therapy. They would then explain how it affected them, their social network and schooling and what they would do to revert. A list of options was given to them to try for the coming weeks and later share their experiences. The following is the diagram describing:
At the end of the research, 48 percent reported being abstinent from drug use since the inception of the treatment, at the 3rd month follow up, 67 percent reported being abstinent.
The larger study from where this sample was drawn, patients rated their clinical encounters as helpful, respectful and culturally sensitive thereby corroborating the results of this study.
Conclusion
Through treatment discussions, in session practice, and homework, participants increased their understanding of how their drug use behaviors, and in turn came to understand the need to cease from drug use towards a more positive way of increasing confidence in their lives. In conclusion, these students appeared to reflect upon their brief treatment experiences as helpful, became more aware of their abuse problem and articulated valuations of their present future.
The aim of the program is to address the drug abuse in parolees and probationers during their probations and decrease the use of drugs in them. The program considered the outcomes of the HOPE program but was implemented according to the local factors that influence drug use in Virginia Estates, Montgomery, AL.
Program Evaluation
To evaluate the program correctly, a sustainable measurement system needs to be developed. To measure the efficiency and effectiveness of a program, various methods can be used that include qualitative and quantitative data. For my program, I will mostly use qualitative data, as it will provide a deeper view of the problem and demonstrate how the participants of the program evaluate it. Interviews, observations, and case studies will be used to assess the program’s efficiency and effectiveness.
The stakeholders of the program (legislators, police officers, judges, probationers, parolees, the general population including parents, young adults, adults, senior citizens, health care providers, etc.) may have concerns about funding as well as public perception. The funding concerns can be expressed in doubts about the initial budget and if it is enough to cover the program. However, analysis of the budget and funding sources has shown that the program can be covered by both funding sources chosen for the program.
Concerns about public perception may be expressed by legislators who will not be sure if the program is able to present the expected outcomes. However, the program is estimated to decrease the crime rates in the community and prevent drug abuse in probationers, decreasing property insurance, and crime rates in the community.
The long-term strategies for the program include attracting medical and education staff to address the parolees’ problems with drug abuse; if the program is proven efficient, the funding can proceed to the second and the third years allowing the stakeholders observe the positive changes in the community: decrease of crime rates, drug abuse, and property insurance cost. The program is able to attract more participants, which will make the probationer officers’ work easier. At last, the program’s potential includes improving the safety status of the community.
Program Goals Achieved
The program goals were achieved as the community members noticed a slight decrease in drug abuse rates; probation officers also confirmed that eight out of ten parolees did not commit any crimes and did not use drugs during their probation. The adult education teacher noticed improvements in probationers’ behavior and their desire to reintegrate into society. Only two parolees did not pass drug tests; they had also missed the lectures provided by the program, stated the adult education teacher in the interview. This fact could explain why the program did not affect these two individuals.
Program Processes Are Effective
To prove that program processes were effective, the author examined a case study of one of the probationers, L.N., who had been participating in the program for twelve months. As the participant noticed, at first he did not believe in the effectiveness of the program. However, he also did not want to experience jail stay again, even a short one. This has helped him to remain abstinent from drugs. Although he did not believe in successful reintegration into society, his aims changed after the program implementation. Now he is actively searching for a job and aims to ask for the custody order to visit his daughter.
Program is Producing Results
To evaluate the program’s effectiveness, statistical analysis was used. The Montgomery Police Department had reported that the number of drug abuse cases in the community decreased from fifteen to eight percent of all cases. Most of the cases did not involve probationers, although two of them also used drugs and were charged with substance abuse.
Program Is Meeting Timeline
From an annual perspective, all goals that were set by the program were achieved. The program did not exceed the one-year period of implementation and provided expected outcomes, i.e. the crime rates in the community and drug use of probationers had decreased. Moreover, the program had helped the probationers reintegrate into the society: some of them were able to find a job by the end of the program, while others appealed for custody or could reunite with their family members. Some of the members stated in the interviews that this year had helped them to overcome drug addiction, although additional therapy is needed to assure the abstinence is successful.
Program Is Operating Within Budget Parameters
As it is required for the budget to demonstrate expected results and provide the outcomes to evaluate if the results are as expected, it is also necessary to show stakeholders that budget parameters are not violated (Cheng, 2008). The funding was leveraged according to the program aims and budget: most of the funding covered salaries and insurances for the staff, as well as rent and medical assistance. To ensure that program funds were being utilized correctly, monthly reports were provided to the funding source. Only if the funding source was not sustainable, the program was entitled to use the other funding source.
Program Has Adequate Resources Available
The primary revenue sources of the program include the Montgomery County Commission in the short term and the Alabama Department of Corrections (ADOC) in the long term. As no alternative to the proposed program exists, it is unlikely that the funding will stop due to the implementation of another similar program. Lack of an alternative was a favorable circumstance during the implementation process.
As the sources of financing will use property and vehicle taxes, as well as court fees and other licenses, its sustainability is expected to remain constant. As the Alabama Department of Corrections exists for more than 30 years and has provided support for various programs during those years, it is possible to assume that ADOC will be a reliable funding source for the program (Thomas, 2014). At last, if both funding sources diminish, a contingency plan will ensure the program has an additional source: Central Alabama Community Foundation that provides funding to programs that target the community and its well-being.
Executive Summary
The program was implemented to reduce the drug use rates in the community Virginia Estates, Montgomery, AL; it has also helped decrease the workload of officers, judges, and attorneys. Probationers who took part in the program were able to overcome drug addiction and reintegrate into the society; some of them were employed by the end of the program, while the others could reunite with their families.
The program, based on the HOPE program implemented from the years 2004 to 2009, reduced crime rates in the community and decreased the cost of property insurance. As the members of the community had stated, it became safer compared to the previous years when probationers committed crimes under the influence of drugs. The number of drug abuse cases has decreased from fifteen to eight percent in the community.
Conclusion
As it is crucial to understand the interests of the stakeholders, the program needs to be evaluated accordingly to show what benefits the community, the stakeholders, the participants, and the funding sources can derive from it (Rubin, 2013). To evaluate the program, interviews, case studies, and the observation method were used. The funding sources of the program were identified as sustainable, and the outcomes of the program were addressed.
References
Cheng, G. (2008). Budget tools: Financial methods in the public sector. New York, NY: CQ Press.
Rubin, I. (2013). The politics of public budgeting: Getting and spending, borrowing and balancing. New York, NY: CQ Press.
Thomas, S. L. (2014). Correctional curriculum evaluation: An uncovering of effective practices that reduce the rate of prison recidivism in the state of Alabama. Boston, MA: Northeastern University.
To implement a program successfully, a detailed, clear budgeting plan is needed. The plan needs to provide information on viable sources, explain what public sources were chosen for the funding, and what plan will be used in case of crisis or unsuccessful/insufficient funding. Moreover, the plan needs to take into account the specifics of the local government, and how it might review the program, accept it as necessary, or decline it. This financial plan was written for the program proposal on decreasing drug abuse in parolees and probationers in Virginia Estates, Montgomery, AL.
Funding Sources/Public Revenues
To implement the program, funding sources need to be identified and analyzed. There are several different revenue sources for local governments, including intergovernmental taxes, own-source revenue, and sources that change (What are the sources of revenue for local governments? 2013). The funding source that can be regarded as suitable for the implemented program is Montgomery County Commission, since, as stated on their website, the Commission controls all public funds of the country.
The Country Administration Office can also be contacted, although it is connected to the Montgomery County Commission, so it is most likely that the Commission’s and Office’s decisions will be similar, if not the same.
Another potential funding source that can be interested in the proposed program is the Alabama Department of Corrections that is located in Montgomery. The program can bring the profit to the Department if drug abuse and crimes, committed by probationers, will decrease. Less money will be invested into the correction programs, and the police department of Montgomery will experience less workload if the probationers are motivated to stay drug-free for a longer period.
Therefore, the first preferred sources for the program are the County Commission and the Alabama Department of Corrections. To fund the program, revenue redistribution can be regarded as a suitable tool. The current correction program in Montgomery that is focused on substance abusers (i.e. drugs, alcohol) is an Intervention Program for Substance Abusers. Its main disadvantages include scheduled testing and sentencing options for drug users who have mild to moderate drug or other substance issues.
The proposed program targets any use of drugs, even the first one after prolonged abstinence. Moreover, all probationers that were caught using drugs are sentenced to a short jail stay. The proposed program provides a more modern approach to the problem, but it targets only the probationers and parolees and not all substance abusers. This might also cause difficulties in implementing the program because the stakeholders that will be interested in it are those who work with the probationers and in the Corrections Department. Nevertheless, the Intervention Program for Substance Abusers mostly targets civilians who do not have any prison sentences.
Revenue redistribution, controlled by the County Commission, will allow to establish non-scheduled testing for all participants, provide short lectures on drug abuse, and, if needed, sponsor the judges’ and police officers’ work during the arrest of the probationer for documented drug abuse. The revenues needed for the program are intergovernmental transfers (i.e. those who come from county governments and municipalities). Although the program may require serious investment at first, it will later reduce the crime rate in the neighborhood, decrease insurance cost and Montgomery police department’s and Montgomery Municipal court’s expenditures on detention, trial, and legal investigation of the cases.
The program can be financed by the Montgomery County Commission in the short term and Alabama Department of Corrections (ADC) in the long term. While funding from the county will not require a big amount of funds at first because the program will not be implemented on a full scale, long-term funding from the ADC will allow it to operate for several years and provide the data to evaluate the outcomes.
Contingency Funding Plan
The public revenues chosen for this financial plan are the non-tax revenues: administrative revenues and grants. Administrative revenues can be summoned in the form of fees and penalties (e.g. fees and penalties ADC charges), while there are several grants represented in the Alabama state (but only one grant is suitable for the program because it targets Montgomery County). As it is also important to raise public awareness of the program and show how this program can help the community, the members of Virginia Estates community who suffer from high crime rates due to poverty need to be informed that this program will reduce drug abuse in the community and increase the well-being of the members, although not significantly, but still notably (Clear, Reisig, & Cole, 2012).
However, both of the funding sources can label the program as not needed since there is one that addresses a similar issue (Intervention Program for Substance Abusers). Moreover, a new program can be suggested during the implementation of this one, so the funds can be cut. In this case, the Central Alabama Community Foundation will be contacted to review the program. Although this type of funding will be short term at first, if the program is proven successful and helpful to the community, it may receive a grant that will cover the next several years.
Expenditures
It is impossible to evaluate or even try to implement a program when the expenditures are not calculated. The calculation of expenditures helps to understand if the choice of funding resources and strategies was correct.
As can be seen, the highest expenditures in the table are rent and lecturer’s salary. Medical assistance can also provide expenditures if the drug testers’ will need to be urgently examined or even hospitalized. The office insurance will cover any possible damage to the equipment and, possibly, the office itself. The equipment, however, can also require additional expenditures because it can be broken, stolen, etc., although insurance will supposedly cover such losses.
Net Cost/Contribution
The program can decrease the crime rates, property damage, Montgomery police department’s workload, home and office insurance in the community (Virginia Estates), possibly even impact the community’s status and the rent cost (which will bring more profit to the leaseholders but less to the tenants). Combined, contributions may bring up to 25 000$ in the first 8-9 months and ca. 60 000$ during the first 24 months of the program implementation. The net cost is thus: 25 000 – 19 400 = 5 600 or 80 000 – 58 100 = 3 900.
Conclusion
The analysis of the program has shown that a financial plan, presented above, is suitable for the implementation of the program; it addresses the major funding sources that are present in Montgomery and Alabama but also suggests a community foundation as a funding source. The expenditures of the program can be covered by the contribution both in the short and long-term versions of the program. A contingency funding plan that can support the program in case of difficulties with implementation was also provided (Bryson & Alston, 2011). The financial plan aims to show that the program is a new and efficient alternative to the existing one in Montgomery, AL.
References
Bryson, J. M., & Alston, F. K. (2011). Creating your strategic plan: A workbook for public and nonprofit organizations. New York, NY: John Wiley & Sons.
Clear, T. R., Reisig, M. D., & Cole, G. F. (2012). American corrections. Toronto, Canada: Nelson Education.
The origin of ACTIQ can be traced to the 1960s when chemist Paul Janssen created fentanyl. Initially, fentanyl was used as an anesthetic because it could produce analgesia without making patients unconscious. Further developments saw the drug gain advance into different forms such as the fentanyl citrate (ACTIQ/oral transmucosal fentanyl citrate (OTFC). While ACTIQ was still being researched, a company named Anesta Corp was accused of publicizing the drug while at the development stage. The drug caused a stir in the cancer care world where it was lauded as the answer to breakthrough cancer pain (BTCP). True to the expectations, ACTIQ possessed an immaculate ability to arrest cancer pain within minutes of it being administered. ACTIQ, also commonly abbreviated as OTFC, is a narcotic (opioid) drug that is prescribed as pain medication for cancer patients who experience BTCP.
BTCP has remained a major challenge to cancer patients for a long time. It is particularly worrying because it defies the ordinary cancer pain medication that patients are often prescribed. Patients who are tolerant of normal cancer pain medication are considered eligible for ACTIQ prescriptions. Despite taking at least 60 mg of morphine or 30 mg of oxycodone daily, such patients do not experience pain relief. Therefore, ACTIQ provides quick relief to breakthrough cancer pain by helping patients to manage this condition. Ordinary painkillers cause a “hurt respite gap”, which is the difference in time between when throbbing reprieve medication is taken and when the patient experiences pain relief. From the onset of its discovery, ACTIQ posed a major risk of being abused. Strictly, the drug is prescribed for cancer patients with breakthrough pain. However, due to its potent capabilities, ACTIQ can be appealing to people who experience different forms of acute pain. The drug is known to be fatal, particularly, to children. It can also pose serious health threats to adults. Notwithstanding, researchers are locked in efforts to determine the usability of ACTIQ to treat chronic non-cancer pain (Webster, Chun, Reinking, Stegman, & Taylor, 2013).
The Pharmacology: How ACTIQ Works in the System
As noted earlier, ACTIQ is a fast-acting prescription drug that arrests pain within minutes of administration. It is normally prescribed after the normal morphine dosage fails to curb cancer BTP. The fast-acting characteristic of ACTIQ is a result of being absorbed in the mucosal lining of the mouth. Once absorbed, ACTIQ attains maximum plasma concentrations within 22 minutes (Changg, Roeland, Atayee, Revta, & Ma, 2015). It navigates the blood-brain barrier faster compared to other opioids, including morphine and oxycodone.
Inside the body, ACTIQ combines with the m-opioid receptors, thus producing analgesia and sedation. Analgesia occurs because the binding of ACTIQ with the said receptors blocks pain pathways, causing pain response to be altered. Sedation, respiratory depression, and a feeling of relaxation also occur alongside analgesia. Simply defined, analgesia is the inability to experience pain. According to Wynn (2011), ACTIQ’s precise mechanism has not been identified. However, the drug’s action is associated with the opioid receptors contained along the spinal cord. Other drugs that have a similar mechanism such as ACTIQ include morphine, codeine, and oxycodone.
How ACTIQ is Grown, Manufactured, Transported, and Marketed
ACTIQ is a synthetic drug that is available as lozenges/lollipops, which are designed to be sucked in the mouth. It is made from reacting fentanyl and citric acid in the relative amount 1:1. ACTIQ is attached to a plastic stick to facilitate holding by the patient while sucking. Ingredients present in the lozenges include dextrose, sucrose, and glycol. ACTIQ is currently manufactured by various licensed companies, including Teva Pharmaceuticals, the company that acquired Cephalon in 2011. Because of the high risk of overdose, misuse, abuse, and addiction, ACTIQ is a strictly regulated drug. The Risk Evaluation and Mitigation Strategy (REMS) is a control program by the Food and Drug Administration (FDA) that monitors how the drug is issued to outpatients, pharmacies, and distributors. REMS requires ACTIQ to be prescribed strictly for opioid-cancer cases, particularly those with BTCP.
The number of pain prescriptions for ACTIQ increased from about half a million in 1994 to nearly 6 million in 2003. This increment is an indication that the drug has grown in popularity, owing to its success in arresting BTCP. However, the marketing of ACTIQ has landed Cephalon in trouble in the past after the company was found guilty of aggressive marketing strategies for unauthorized uses. The company was ordered to pay $425 million in a suit filed on behalf of the US government. While off-label prescriptions of ACTIQ are permissible for the part of physicians, pharmaceutical companies are barred from marketing drugs for off-label uses because such a practice poses a major risk since the drug can be accessed by the wrong people. For instance, the amount of ACTIQ circulating illegally has continued to increase, owing to activities such as theft and selling in the black market. ACTIQ as an abused drug is used for its sedative properties.
The Dosage, Expected Effects, Side Effects, and Potential for Overdose
Dosage
ACTIQ is a highly potent drug that is about 100 times more powerful compared to morphine. For this reason, it is to be taken in small doses. To begin with, the drug is only available for use by cancer patients who develop BTCP (Chang et al., 2015). In other words, a patient must experience pain that cannot be managed by ordinary opioid-based medication. The ACTIQ dosage is administered by way of mouth whereby the patient sucks on the lozenge/lollipop. It is designed this way to facilitate quick absorption through the buccal cavity, hence initiating fast action. The method ensures that a minimal relief gap exists. Also, the lollipop design makes it difficult for the patient to accidentally swallow the unit. While swallowing may not pose a risk to an adult patient, it inhibits the drug’s action inside the body because absorption in the intestine occurs much slowly compared to assimilation in the mouth. As such, about 25 percent of the ACTIQ unit should be absorbed through the mouth cavity, a process that takes about 15 minutes. Afterward, the patient may swallow the remaining part, which will then be gradually absorbed in the intestinal region.
A single dose of ACTIQ contains about 200 micrograms of the drug in one lozenge/unit. As explained above, the patient is required to suck the unit to allow the drug to be taken gradually into the body. Usually, no standard dosage can render analgesia across all the patients’ cases. Instead, what constitutes enough dosage depends on an individual’s severity of pain, response to the drug, as well as the risk of developing side effects. Nevertheless, it is strictly required that patients should not take more than two units per BTCP episode. This plan serves as a precaution against possible misuse and hence fatal overdosing. Patients are advised to stop administration once pain ceases since this outcome indicates that they have reached an adequate dosage. Importantly, four hours should elapse before the patient can commence treatment for a subsequent episode. Sometimes, patients may skip a dosage. However, this case is uncommon in pain medication (Kuip, Zandvliet, Mathijssen, & Van der Rijt, 2012). In the event this happens, the patient is advised to ignore the skipped dosage to avoid possible overdoing. Also, since ACTIQ is a pain medication substance, no serious side effects of skipping a dosage have been witnessed.
Expected Effects
The obvious effect is the arresting of pain within a short period of administration. By arresting the pain receptors in the spinal cord, ACTIQ causes the transmission of pain to be inhibited. As a result, the patient experiences pain relief (analgesia), beginning within the first 5 minutes of oral intake. The effect of ACTIQ in the body lasts for about 2 hours during which the breakthrough episode is expected to have subsided. A relaxed feeling will also accompany the analgesia lasting almost the same period. According to Wynn (2011), some patients may experience mild-to-intense mental impairment (confusion). Blurry vision has been reported at night. It is for this reason that users are advised to avoid driving or operating heavy machinery before figuring out how ACTIQ affects their level of alertness.
Side Effects
ACTIQ demonstrates a wide range of side effects depending on the patient’s tolerance and the amount of dosage. The most common side effects, which mostly affect about 10% of users, include respiratory depression, diarrhea, constipation, nausea, dry mouth, and confusion. Other less common side effects are sweating, headache, anorexia, and nervousness. Slowed breathing can also occur in extremely rare circumstances, except if occasioned by an overdose. In the event of an overdose, the breathing problem could become fatal. Some grave side effects also occur when ACTIQ is combined with other substances. On top of the list is alcohol, which has been shown to cause serious reactions when taken with pain medication.
Particularly, opioid medications if taken with alcohol may cause death (McWilliams & Fallon, 2013). Grapefruits and (grape) juices also cause harmful reactions if taken within a short period of having ACTIQ. To avoid reactions, patients are always advised to avoid eating or drinking anything alongside ACTIQ. Another serious side effect of ACTIQ is tooth decay. ACTIQ contains at least eight calories (2 grams) of sugar per lozenge, a factor that has been associated with widespread tooth crumbling in users. Following an outcry by affected patients and a subsequent story that showed Cephalon’s plans to release a sugar-free lozenge (Actiq, 2012). However, this version of the drug is yet to appear. Instead, the company and physicians strongly advise users to maintain high levels of dental hygiene to avoid tooth decay.
Potential for Overdose
Concerns over the possible overdose of ACTIQ are ever-present. These concerns result from the high incidence of overdose cases, many of which have resulted in fatalities. Fatalities often occur when the patient fails to seek medical assistance after overdosing. According to Chang et al. (2015), the number of overdose cases of fentanyl-based products in the US rose from 9,000in 2004 to over 20, 000 in 2008, despite a mitigation strategy (REMS) being in place aimed at preventing overdose and non-medical use of ACTIQ. Overdose can be identified by establishing any one of the following side effects:
Sluggish/trouble in breathing
Fainting
Amassing of liquids in the lungs
Convulsion
Incapability to talk/stroll
Dawdling heartbeat
The above list is not conclusive since effects are likely to vary depending on the patient’s tolerance level. Besides, being on other medication or having other medical conditions can result in unpredicted side effects (Chang et al., 2015). Pain medications are among the most commonly abused prescription drugs in the United States. ACTIQ specifically belongs in the aforementioned opioid class that registers high numbers of overdose cases. One of the lead causes of an overdose of ACTIQ is improper prescriptions. As Webster et al. (2013) explain, ACTIQ has a much higher potency compared to other opioid drugs. As such, a patient transitioning from another opioid/fentanyl drugs should be given a much smaller prescription (200mcg) at the begging of such transition. However, physicians may sometimes issue a prescription similar to that of less potent medication that the patient was using previously. Similarly, the patient may plan to take a dose of ACTIQ that is similar to that of a previous but less potent drug, thus overdosing.
Specific Treatments that Might be Used in Rehabilitation
Abuse and misuse of fentanyl have become common over the years, having begun from within the medical profession in the 1970s. The first cases of abuse involved in medical professionals. Soon, the drug was being sold as an abuse substance across the world. Due to its widespread abuse, ACTIQ addiction has become a major challenge in the fight against narcotics. ACTIQ appears harmless probably because it is often referred to as ‘lollipop.’ However, its side effects are dire. On many occasions, one may suffer addiction. ACTIQ addiction can be extremely difficult to cure because it is a powerful narcotic. As such, quitting the drug abruptly and without guidance by a specialist can lead to nasty withdrawal symptoms and complications.
Rehabilitation is the recommended approach to dealing with ACTIQ addiction. Rehabilitation services are classified into outpatient and inpatient. Outpatient rehabilitation involves attending a treatment program while living at home. One advantage of outpatient care is that patients can live at home and go on about their day-to-day life. They may receive moral support from family members. However, certain drawbacks are associated with outpatient rehabilitative care. First, ACTIQ is a potentially dangerous drug, which requires close monitoring by a physician. Besides, outpatient care presents the patient with many opportunities to access the drug, a situation that can lead to a relapse.
An inpatient/residential rehabilitation program is the most suitable approach to treating patients with ACTIQ addiction. It involves a comprehensive and intensive approach that offers consistent support for addicts. Specific treatments under the inpatient program may include detox, therapy/peer groups, and coping skills to address the risk of relapse (Webster et al., 2013). Certain prescriptions are also available to arrest withdrawal symptoms occasioned by the discontinuation of use. Inpatient rehabilitative care is usually more costly compared to outpatient, but the benefits of the former make it a worthy investment. Besides, inpatient rehabilitation is categorized into three types of programs, depending on the services offered. These services include typical, classified/magnificent and, supervisory treatment programs.
The length of inpatient treatment depends on the following factors:
The rigorousness of the compulsion
The patient’s record of treatment (e.g., cases of reversion)
Individual desires of the patient
Monetary resources: Rehabilitative care is a finance-intensive treatment
Presence/absence of support at home or in the community
Conclusion
ACTIQ is one of the different drugs found under a category of opioids known as fentanyl. It is sold as lozenge units, each ranging between 200 and 1600 mcg. ACTIQ’s strength and ability to arrest BTCP pain has caused the drug to become popular in cancer treatment. However, only opioid-tolerant cancer patients should be prescribed to ACTIQ. While the standard dosage is 200 mcg, patients achieve analgesia differently because of many varying factors such as drug tolerance. For this reason, physicians should avail just the right amount to bring about analgesia in the patient. The administration of the drug is by way of mouth to attain rapid absorption. Conversely, swallowing the lozenge (before sucking first) may diminish the absorbability, hence making it less effective. ACTIQ is a commonly abused drug where people use it as an ordinary narcotic. This situation has resulted in deaths related to abuse and overdose. REMS is a control program established by the FDA to ensure that ACTIQ is not obtained for the wrong use. Nevertheless, the drug is still being abused at a worrying rate. Other than abuse, patients also commonly misuse prescribed ACTIQ by taking the wrong dosages. Physicians are advised to keep track of their patients, particularly those in the outpatient programs to ensure they stick to the prescribed dosages. Finally, switching between ACTIQ and other types of fentanyl requires a new prescription to avoid an overdose. If carefully utilized, ACTIQ can assist BTCP patients to live normal lives while taking the normal round-the-clock opioid prescription.
References
Actiq: Drug safety beta. (2012). Web.
Chang, A., Roeland, E. J., Atayee, R. S., Revta, C., & Ma, J. D. (2015). Transmucosal immediate-release fentanyl for breakthrough cancer pain: Opportunities and challenges for use in palliative care. Journal of Pain & Palliative Care Pharmacotherapy, 29(3), 247-260.
Kuip, E., Zandvliet, M. L., Mathijssen, R., & Van der Rijt, C. (2012). Pharmacological and clinical aspects of immediate release fentanyl preparations: Criteria for selection. European Journal of Hospital Pharmacy: Science and Practice, 19(1), 38-40.
McWilliams, K., & Fallon, M. (2013). Fast-acting fentanyl preparations and pain management. QJM, 106(10), 887-890.
Webster, L. R., Chun, S. Y., Reinking, J., Stegman, M., & Taylor, D. (2013). Oral transmucosal fentanyl citrate use in chronic noncancer pain: A retrospective survey. Web.
Wynn, R. L. (2011). The sugar-loaded fentanyl lollipop (ACTIQ) and the risk for tooth decay. Gen Dent, 59(3), 168-170.
Identification of the Public Health Challenge in the Article
The article under analysis aims to analyze university students from Lebanon and their knowledge of prescription drug abuse, including such aspects as prevalence, sources, and motivation. The authors state that the non-medical use of drugs is one of the major topics for discussion in many countries (Ghandour, Sayed, & Martins, 2012). To investigate the chosen topic, the authors develop several important research questions, including the clarification of the most frequently used prescription medications, the reasons for use, and perceptions of young Lebanese on the access of such drugs.
Identification of the Authors and Source of the Article
“Prevalence and Patterns of Commonly Abused Psychoactive Prescription Drugs in a Sample of University Students from Lebanon: An Opportunity for Cross-Cultural Comparison” is the article written by Ghandour, Sayed, and Martins for the journal Drug and Alcohol Dependence in 2012. The first two authors are the representatives of the Department of Epidemiology and Population Health at the American University of Beirut, and Martins is from the Department of Mental Health, the John Hopkins University.
Statement of the Rationale for Selection of the Article
The article is chosen for the analysis for three important reasons. First, the topic of the article is open for discussion. It is necessary to clarify what American researchers think of prescription drug abuse and the perceptions of young people on this topic. Second, the structure of the article is clear. It is not complicated to identify the main issues and the directions chosen by the authors of the article. In the abstract, Ghandour et al. (2012) introduce the reasons and the results of their study. Therefore, it is possible to conclude if the chosen approach is interesting for reading and helpful for discussing the topic of prescription drug abuse.
Summary of the Key Points in the Article
In the article, the authors identify the method that is used to answer the chosen research question and explore on prescription drug abuse. An IRB-approved cross-sectional study based on an anonymous questionnaire was developed at the American University of Beirut. The key points of the article include the reasons why young people are eager to use drugs without appropriate prescriptions, the outcomes of such use that could be observed among the students of Lebanon and the recommendations that could be given regarding the current state of affairs. The main reasons include pain, sleepiness, anxiety, and the need for stimulants. Gender differences do not play an important role in this kind of dependence. Also, it was concluded that young people can find the required pain relief or stimulants easily without giving any clarifications. Medical supervision is not the main issue for consideration in the country. Finally, the authors conclude that new relevant policies and the rise of awareness of medical supervision and drug misuse are required for American society as well as for other nations.
General Clarity of the Content of the Article
Taking into consideration the goals and the development of the article, it is possible to say that the article’s content is clear, reaching point 9 on the scale. The only shortage of the work is the inability to find a list of recommendations that could be given after the case of abused psychoactive prescription drugs is proved. A sample is chosen and explained properly, and the methods are identified and used clearly. Finally, the results and discussion sections contain enough information to prove the correctness of the choices and the work. At the end of the article, the achievements of the authors and the importance of the study are discussed in a clear way to provide the reader with an ability to comprehend what kind of work could be done based on this study.
Quality of Contributions to Knowledge of the Challenges to Public Health from a Global Perspective
In the article, it is hard to define the quality of contributions to the knowledge of the prescription drug abuse challenge to public health from a global perspective. Still, it is possible to find several references to a global perspective. First, the authors use global trends to clarify what the youth of Lebanon think about prescription medication use (Ghandour et al., 2012). Then global trends were identified in the discussion to prove that an opportunity to conduct cross-national comparison has not yet been used. Finally, the authors suggest using a global phenomenon and developing effective research in the future using the data obtained.
Conclusion
Regarding the checklists offered, it is possible to say that the chosen article meets the majority of the criteria. It has a focused question with the help of which the authors make a right direction and use the right type of papers. Up-to-date, peer-reviewed articles and reports are used to support the main ideas. The study is worth continuing because the challenge was proved and the topic of prescription drug abuse was properly developed. The only task that should be done is the development of effective policies and guidelines for young people to follow to avoid medication problems. In general, the results of the study were combined and explained in terms of further applications and improvements. Though no clear numbers were given, the findings provide a good opportunity to compare human behaviors regarding different cultures and to highlight contextual differences.
Reference
Ghandour, L.A., Sayed, D.S.E., & Martins, S.S. (2012). Prevalence and patterns of commonly abused psychoactive prescription drugs in a sample of university students from Lebanon: An opportunity for cross-cultural. Drug and Alcohol Dependence, 121, 110-117.
Education is usually the key element a government is supposed to put more effort into so as to bring development in various issues of life. For this case, the ministry concerned has a very hard task of ensuring there are no critical issues that are left unsolved that relate to education, failure to which will affect the performance of students in schools which in turn affect the economic growth of the country (Provenzo, 2006).
Drug Abuse and Alcoholism
Drug abuse and alcoholism among the students are one critical issue in education that is usually overlooked when it comes to tackling critical issues in education. Many students in both public and private schools abuse drugs and take alcohol, and as a result, performance in school has significantly deteriorated.
Many students get involved in drug abuse and alcoholism in schools as a result of peer influence. As a result, they become drug addicts, and for this case, they lose concentration in class. When students are under the control of drugs, understanding any concept in class becomes a problem since their mind is just thinking about their next drug-taking session in class.
Students who take drugs tend to have deviant behaviors such as bullying others; they become violent and, at a time, even stealing. Since they purchase drugs out of the little pocket money they are issued to them by the parent, they tend to source more money by stealing from other students and even neighbors. This is to ensure they have enough money to buy drugs they have already gotten addicted to it. Many parents end up spending a lot of money when trying to rehabilitate their sons and daughters from diseases related to drug abuse and alcoholism. Some students end up even dropping from school as a result of staying for many months or even years in the rehabilitation centers. Some students even become drug peddlers and traffickers, which is a serious crime according to the law and they end spending most part of their lives in prisons (Provenzo, 2006).
The adolescence stage is a very crucial stage in life that comes up when a student is in high school, and for this case, the students require proper guidance and counseling since they usually think they can make their own decision. This is a very difficult stage in the human growth and development of an individual who must be guided on how to go about difficult challenges in life. This is the stage many students begin using drugs such as cigarettes, alcohol, cocaine, and Cannabis sativa.
Conclusion
The issue of drug abuse and alcoholism should be taken more seriously by the government and school administrators to ensure that students do not get involved in drug abuse and alcoholism. For this case, the measure should be taken to counsel those students already taking drugs in an effort to rehabilitate them. Education standard will not improve if drug abuse and alcoholism in schools are not controlled. This will, in turn, lower the economic development of our country that solely depends on the human resources of the citizens, and if the schools will not produce a competent workforce, it means there will be no development. This will mean the country will have to hire expertise from other countries, which is very expensive and as result, this expertise spend their money in their home country instead of our country. Our country will be very resourceful as far as human resource in various fields is concerned if we fight drug abuse and alcoholism in our school and economic development of our country will always be improving.
References
Lewis, J.J., Bookbinder, R.M. and Bauer, R.R. (1999): Critical Issues in Education: A Problem-Solving Guide for School Administrators: New York, Prentice Hall
Provenzo, E.F. (2006): Critical Issues in Education: an Anthology of Reading, London, Sage Publication
Drug abuse refers to the use of illegal substances or misusing drugs prescribed by a Doctor in excess amounts thus resulting into substantial medical harm and misery due the repeated usage of and overdependence on the substance. (MedicineNet.com).
It is the saddest thing to see someone expose themselves to the dangers of drug abuse. I say expose themselves because, if at all someone is not abusing drugs because of a mental or psychological problem, then it just a matter of personal choice for an individual to abuse or not to abuse drugs.
Discussion
During my time in high school and college I saw many students who became victims of drug abuse. In my community I have met people who are completely destroyed by drugs financially, emotionally, psychologically and even socially. It has broken families. It is not pleasing to see the potential in the youth of our society to be wasted. The problems brought by drug abuse are enormous, compounded by the financial implications especially for those in low income bracket.
In college I joined a guidance and counseling association where we were trained in counseling our peers in the college against drug abuse. During the holidays I also joined a guidance and counseling organization which is also a member of the Community Anti Drug Coalitions of America. In those organizations I met different people with various experiences of drug abuse. Those encounters had a big role in shaping my desire to want to help change the lives of those who had this problem of drug abuse. During my time in the above organizations we planned for various campaigns against drug abuse and held education forums for college, high school and also community drug abuse education programs. I have also been very instrumental in contributing to the newsletters produced by these organizations which aim at educating the youth and parents against drug abuse.
Through these organizations we also organized various awards and ceremonies and still do, to promote awareness of the problem of drug abuse. In order to move to a higher level with my efforts in serving my community I decided to take up the graduate education in social work. I figured out that with an increased education in this field I can be able to better understand my work and be a positions where I can be able to implement changes that affect people positively more efficiently.
Loyola University, School of Social Work has a Nonprofit Management and Philanthropy Sector Program that teaches leaders coming from both the public and private areas of philanthropy to better give service to the general society. Through this program, participants are able to acquire various skills which are pertinent to an individual involved in social work. Some of the leadership skills that one is equipped with through this program are raising of funds for use in social work, the management of non profit making organizations, planning at the strategic level of management, giving grants and donations and most of all they develop an understanding of how the charity organizations function.(Loyola University Chicago).
Loyola University School of Social Work has a great contribution towards training the leaders who are given to serving others, serving the society, mankind. The issue that I am dealing with is the counseling of the drug abuse victims. Most of the victims we meet are some of the downtrodden of the society, people who need to be helped and be reaccepted into the society so as to become productive members again. This is a task that requires professional skills in terms of management of the rehabilitation institutions in which it is carried out and of course funds for running the institutions themselves. Most of the funds for these institutions usually come from grants or donations from various organizations. It is in this aspect that the contribution of Loyola University is most needed in the support of the task I have taken.
The principles of the National Association of Social Workers are also supportive of the kind of work that I have chosen to be involved in especially in the promotion of social justice. This is in the sense that, in a society there are different people with different lifestyles and of course accompanied with different kinds of problems. There are those who are enlightened, educated and financially well off. On the other extreme we have the members of the society who are not so well educated, the poor living in the poor neighborhoods and mostly these are the people who are adversely affected by the brunt of drug abuse. They are the ones mostly exposed to the drugs and the drug dealers.
Education is a basic human right, more so when it is targeted at helping change an individual’s life, because in a situation where drug abuse is due to ignorance, the difference between the amounts of information one has on drugs can mean either life or death. Through service to the society, these principles are satisfied and by providing social justice, a responsibility for all of us to work towards helping the other less fortunate members of the society. (NASW, 2008). Through social work, the campaigns against drug abuse, the general educational forums and the counseling of the victims and final rehabilitation, social justice can be done and the rehabilitated people can be able to work and fend for themselves.
In the social work profession, there are various researches looking into different ways of how social work can be integrated into different aspects of the society. With respect to social work and the problem of substance abuse, research has been carried out in terms of investigating the relationship between drug abuse and poverty, the effects of drug abuse on the society. Some of the questions that can be used as guides in this effort are: what is the income bracket of the drug abuse victims, in which parts of the community do the drug abuse victims live, what percentage of the drug abuse victims live in the poor neighborhoods and what is the highest education level attained by the victims.
Given that there is scarcely if any, efforts directed towards alleviating poverty as a way of reducing the prevalence of drug abuse especially among the poor, I have seen that there is a way in which this can be explored and I am putting my efforts into it. My vision for my professional work is to go further into looking into the aspects of social work that I feel have been neglected. In this case I may have lots of hurdles ahead, but with promise of great achievement in my endeavors.
In order to improve the social work professions response to the issue of direct relationship between drug abuse and poverty, it will be helpful to highlight the problem in the specific areas and do a lot of awareness campaigns. Carrying out and publishing a research into the issue will also do a lot in improving the response.
During my study course in high school, I studied Biology with various topics that covered the human biology ranging from the structure of the cell and the functions, genetics, human anatomy and human physiology. Under these topics we covered drugs and their effects on the human body and reproduction. Some of the drugs that we learned about are cocaine, alcohol, nicotine, marijuana and khat (a stimulant known in some countries as miraa).
Reference
Loyola University Chicago. School of Social work. Philanthropy NMPS. 2008. Web.
Substance misuse is one of the most significant problems in American society. Thousands of people have various health issues associated with drugs, which negatively affects the well-being of the nation. Young people are especially sensitive to this matter due to the nature of psychological development. Their values are easily manipulated by mass culture, making movies and music a powerful tool of promoting a certain type of behavior.
Moreover, socio-economic factors are also very significant regarding decisions of adolescents to engage in substance misuse. The combination of a surrounding and personal values creates an individual background that may predict the likeness of engagement in drug abuse, yet it is subject to changes, which can be used for developing solutions for the issue. The paper analyzes studies regarding some of the most widespread types of substances, as well as discusses the role of the rap culture in the growing number of young addicts in the U.S.
Background
Drug abuse is a global issue, and the United States is one of the countries that seek to resolve it. Recent data reporting suggests that there are about 22 million people in the U.S. older than twelve years who are engaged in illicit drugs use (Yur’yev & Akerele, 2016). Currently, these substances are controlled by the government and fall under different classification systems. For instance, some drugs may be characterized as either medical or recreational according to the purpose of use. Thus, twenty-one states allow by law the trade of marijuana for people who have certain health conditions (Hasin et al., 2015).
However, there is a high risk of people buying it for recreational purposes. Prescription opioids form another group of substances that are officially allowed, yet non-medical use is one of the consistent issues in this field. Reports suggest that the misuse of this type of drugs is associated with an increasing rate of deaths in the U.S. over the past several decades and has now taken a form of an epidemic (Han, Compton, Jones, & Cai, 2015). There are debates on whether making certain substances legal or partially accessible encourages more people to try them.
However, decisions regarding drugs misuse are mainly guided by free will, and it is important to identify the driving factors that lead people to such behavior. For example, it is claimed that individuals learn from their life experience as well as follow model traits provided by popular culture (Acosta, 2017). Nowadays, substance misuse is often mentioned in movies and music, the latter especially associated with the hip-hop culture. While it becomes more popular among young people each year, it is crucial to change the glorifying tone surrounding the topic and provide truthful information about the risks carried by this type of behavior.
Literature Review
To better understand the essence of the drug abuse issue among young people in the U.S., it is important to identify the extent of the problem, including the current situation overview and the factors leading to it. In particular, it is crucial to understand how strongly a socio-demographic status is influencing an individual’s decision to adopt substance misuse. This section discusses articles regarding background characteristics of adolescents who have had experience with prescribed opioids, crack cocaine or marijuana. It is important to note that the data was collected by surveying and there are limitations associated with inaccuracy, incomplete population representation, incorrect or false answers, and other issues typical for this methodology.
Prescribed Opioids
Currently, several types of opioid-based medications can be prescribed to patients across the U.S. Han et al. mention that the number of deaths and emergency visits caused by overdose cases of these substances has increased dramatically since the end of the past century (2015). They have conducted a major study aiming to determine groups that are most vulnerable to this problem among people aged between 18 and 64. The research focused primarily on socio-demographic factors that may potentially influence the wellbeing of an individual.
The study was conducted based on the data collected from surveys. It consisted of answers from people questioned in 2003-2013 by the Substance Abuse and Mental Health Services Administration (Han et al., 2015). Another source of information was the National Vital Statistics System, covering the question of deaths caused by medical opioids overdose. The results revealed that several demographic factors might be determining an individual’s choice to have a non-medical use of opioids.
For example, people who had such experience were also likely to possess a low level of education, having a high school diploma or less. Another risk factor was a low-paid job or the absence of thereof. Having no insurance or being covered by Medicaid was also a characteristic for drug abusers more than for people who never had such an experience. Finally, depressive mental states, nicotine, and other dependencies were among the background factors of non-medical opioids users more times than for individuals not engaged in the practice.
The study has revealed that socio-economic problems like the lack of a decent job or education may push people towards drug abuse. The findings are especially important for analyzing the situation among youth since this group is usually economically unstable and sometimes dependable on their older relatives. The case heavily relies on the overall state of the country’s wellbeing, and difficulties in social spheres may further develop the prescribed opioids epidemic.
Crack Cocaine
Crack cocaine is one of the most popular drugs among young people. According to statistics, there are approximately 1.4 million Americans who use it for recreation purposes (Yur’yev & Akerele, 2016). Its popularity is explained by the price that is lower than for other drugs like powder cocaine. The study by Yur’yev and Akerele (2016) is valuable for researching this topic since it covers all segments of the population. Similar to the article discussed above, the researchers tried to determine a demographic portrait of individuals consuming crack cocaine.
The findings for the study were comparable to those defined for non-medical opioid use. Thus, poor education and low-income level were named among the characteristics of people with a history of experience with crack cocaine (Yur’yev & Akerele, 2016). The absence of satisfaction with life also turned out to be one of the factors. At the same time, the researchers paid more attention to a family as a background element. The results showed that single or divorced people were more likely using crack cocaine than those who were married. Besides, men were accounted for more cases of this type of drug abuse than women. Another important finding was the absence of correlation between race and crack cocaine use.
The research supports the idea from the previous study about the importance of socio-economic factors regarding the issue. The accuracy of this assumption is supported by the logic that people who are happy among their family and friends and successful at work do not have time for destructive behavior. Unfortunately, young people lack some of the mentioned characteristics and possess a relatively large amount of free time which allows them to experiment with risky activities.
Marijuana
Nowadays, many people view marijuana as a substance that is even less harmful than alcohol, which is sold legally in most countries in the world. However, its use carries many risks, especially for young people. Some studies suggest that adolescents who engage in smoking cannabis suffer from “altered brain development, cognitive impairment, chronic bronchitis, and adverse mental health outcomes” (Taylor et al., 2017, p. 764).
Moreover, marijuana may serve as a gateway for heavier drugs in the future. The study by Taylor et al. (2017) revealed the importance of socio-demographic factors associated with the issue, as the population consisting of about 14,000 young people born in 1991-1992 was surveyed. Adolescents belonged to different backgrounds, which affected their use of cannabis.
Similar to the articles mentioned above, this study identified demographic elements that prevailed in the population that had experience with marijuana. For instance, poor housing condition like subsidized or rented apartments was associated with regular cannabis use by children in the future (Taylor et al., 2017). However, the researchers did not find a direct correlation between social wellbeing and the issue. There were differences in patterns between regular and occasional use of cannabis. Nevertheless, there was a strong connection between the former and the harmful behavior in the older age.
Being a much-discussed substance in the society, marijuana can possibly become legal for medical purposes in many states. Hasin et al. (2015) studied the correlation between the adoption of a law legalizing cannabis for medical purposes and the frequency of its use. It appeared that states which passed such legislation also had more marijuana users than those who did not. At the same time, there was no evidence of those numbers increasing over the following years. Thus, there does not seem to be a connection between legalizing cannabis and its medical use, yet the data for recreational purposes may differ.
The Role of Mass Culture
The ideas promoted through television and the Internet are especially powerful among young people. Unfortunately, modern mass culture in the U.S. often portrays alcohol and drug abuse as a positive trait. The article by Gabriela Acosta (2017) provides an extensive summary of the number of mentioning of those substances in pop music for the ten-year period starting from 2007. It appears that more than 20 percent of all Billboard’s Hot 100 year-end charts compositions included at least one mentioning of alcohol in various forms (Acosta, 2017). Since musicians often act as role models for young people, their lyrics may serve as a type of lifestyle propaganda.
Rap and hip-hop are the genres often associated with the extensive use of drug themes in lyrics. The analysis shows that they are accounted for more than 70 percent of substance mentioning (Acosta, 2017). At the same time, the trend seems to be changing in recent years. The article by Matt Gonzales (2017) discusses this development based on the studies conducted at different times. For example, ten years ago drug abuse was glamorized by rap singers, and nowadays many of them share opinions about the risks and harm of this practice. The movie industry is also following this trend, showing alternative lifestyle scenarios.
For example, Love Beats Rhymes (Hall & RZA, 2017) depicts a story of a young rapper Coco who wishes to record an album with a popular hip-hop label. Unlike similar stories, the movie does not raise the theme of drugs at all. On the contrary, it shows how a girl from a low-income family becomes successful by attending college and taking a poetry class, which eventually helps her to write better songs. Love Beats Rhymes is a great example for young people with a lower-class background, which are especially sensitive to drug abuse according to the discussed studies.
Conclusion
The issue of drug abuse is prevalent in U.S. society. Socio-demographic factors like education and income level strongly influence people’s choices regarding it. Young people are especially vulnerable to this situation, as they are additionally pressured by the mass culture with its positive portrayal of drugs misuse. However, the situation is currently changing, and there are examples of music movies that show social groups like rappers who do not engage in these harmful activities.
Hall, P. (Producer), & RZA (Director). (2017). Love beats rhymes. United States: Codeblack Films.
Han, B., Compton, W. M., Jones, C. M., & Cai, R. (2015). Nonmedical prescription opioid use and use disorders among adults aged 18 through 64 years in the United States, 2000-2013. JAMA, 314(14), 1468-1478. Web.
Hasin, D. S., Wall, M., Keyes, K. M., Cerda, M., Schulenberg, J., O’Malley, P. M., … Feng, T. (2015). Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: Results from annual, repeated cross-sectional surveys. The Lancet Psychiatry, 2(7), 601-608. Web.
Taylor, M., Collin, S. M., Munafo, M. R., MacLeod, J., Hickman, M., & Heron, J. (2017). Patterns of cannabis use during adolescence and their association with harmful substance use behaviour: Findings from a UK birth cohort. Journal of Epidemiology and Community Health, 71(8), 764-770. Web.
Yur’yev, A., & Akerele, E. (2016). Socio-demographic characteristics of individuals with history of crack cocaine use in the US general population. Community Mental Health Journal, 52(8), 1043-1046. Web.
To ensure that the collaboration aimed at eliminating the effects of heroin addiction is successful and effective, an important condition is informed decision-making. According to Zhang, Tan, Hao, and Deng (2017) who describe their research, a community-based integrated model “is highly feasible with high treatment retention” (p. 54046). An appropriate working environment should be created where participants can share experiences and important information regarding the intervention. The involvement of stakeholders is an essential condition for the effectiveness of this model of work and its results, and all the roles should be allocated in accordance with the capabilities of the program’s participants.
The Ways of Stakeholders’ Collaboration
Collaboration opportunities for the intervention may be open to all. The role of professional medical experts-narcologists is to monitor the progress of work and control the results, noting all the nuances. Leaders should head working groups and allocate responsibilities among the participants of the intervention. Various agencies and political representatives can act as supervisory boards and provide formal opportunities for specific procedures. As Luchenski et al. (2018) note, “dedicated resources and better collaboration” are needed for positive outcomes. Therefore, contact may be established with different stakeholders.
Skills Needed for the Leader of the Collaboration
When in the role of the leader of the collaboration, it is significant to take into account the strengths of all the stakeholders and allocate responsibilities effectively. According to Molfenter et al. (2017), organizational leadership and culture support the plan of intervention and contribute to maintaining the positive working environment. It is possible to succeed by showing patience and not demanding too much since the task is not easy, and a step-by-step solution is likely to be more effective than an attempt to solve the problem in the shortest possible time.
Trends to Follow
In the process of the intervention aimed at helping people with heroin addiction, certain trends should be observed so that the work could be as effective as possible. As Singh and Gupta (2017) remark, the gender factor is to be taken into account. According to the authors, “the impact of drug use tends to be greater on women, because women lack access to care for drug dependence” (p. 186). Also, another trend that can be useful is group therapy. Sometimes it is difficult for people with severe drug addiction to decide on treatment because of various reasons – embarrassment, shame, uncertainty in a final result, and other causes. However, in the case of collective sessions, a common problem allows people to rally and shows them that their issue is not unique and some members of society also need medical assistance.
Actions to Enhance Professional Development
In order to enhance professional development and achieve higher results in personal preparation for working on the strategies needed for the intervention, statistical data presented in the academic literature should be carefully studied. According to Volkow and McLellan (2016), “28,647 drug overdose deaths (61%) in 2014 in the United States involved some type of opioid, including heroin” (p. 1258). These figures indicate that it is essential to analyze all available information and draw conclusions regarding the patterns, taking into account different factors (gender, age, etc.).
Another significant action is acquaintance with people who need medical help and conversations with them. In order to have an idea of the problem, it is necessary to obtain relevant information directly from patients themselves, conducting relevant surveys and assessing the degree of interest of the target group in performing the intervention. Having such information, it is possible to start from specific issues that disturb patients and make work as much effective as possible.
References
Luchenski, S., Maguire, N., Aldridge, R. W., Hayward, A., Story, A., Perri, P.,… Hewett, N. (2018). What works in inclusion health: Overview of effective interventions for marginalised and excluded populations. The Lancet, 391(10117), 266-280. Web.
Molfenter, T., Knudsen, H. K., Brown, R., Jacobson, N., Horst, J., Van Etten, M.,… Toy, A. (2017). Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: Protocol for a cluster randomized trial. Implementation Science, 12(1), 135-143. Web.
Singh, J., & Gupta, P. K. (2017). Drug addiction: Current trends and management. The International Journal of Indian Psychology, 5(1), 186-201. Web.
Volkow, N. D., & McLellan, A. T. (2016). Opioid abuse in chronic pain – Misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), 1253-1263. Web.
Zhang, H. H., Tan, L. X., Hao, W., & Deng, Q. J. (2017). Evaluation of a community-based integrated heroin addiction treatment model in Chinese patients. Oncotarget, 8(33), 54046-54053. Web.
There has to be a preventive strategy in every intervention procedure to avoid the occurrence of a disease (Straussner, 2012). I find the course of treatment in this intervention beneficial for the creation of the needed preventive measures. I have chosen CBT as my preferred intervention in this treatment. The treatment interventions suggested include attending a 12-step program that will be scheduled three times a week. This will be done until the client registers notable improvements. The client will also be required t meet with a social worker for personalized counseling social for the next six weeks. Medication management will be monitored through a once every month scheduled meeting with the psychiatrist.
The client has several strengths, including the fact that she enjoys working out and running as part of physical activity to keep fit. She also enjoys a good relationship with her four children because she loves children. She used to work as a teacher before depression overwhelmed her. She indicated that she would like to return to teaching when the depression is under control.
In this Biopsychosocial work, I have achieved several things.
Through this social work experience, I understood my profession’s strengths, limitations, and areas where improvement is required. This has also helped me identify my strengths and weaknesses and places where I need to improve. I have realized that smokers smoke for varied reasons, but there is one common reason for all. They all have underlying psychological issues that they intend to suppress by getting high on the drug. During this fieldwork, I hoped to accomplish other goals, but it was difficult to do so with the limited kind of approach.
I wanted to prove that drugs use, especially marijuana, increases the rate of crime. It is a widespread belief that drug-users are more prone to committing suicide than those who do not use drugs. This rationale has been used repeatedly to try to scare non-smokers from engaging in the use of marijuana. However, in my work, I was proven wrong when the Pt denied being involved in any legal issues or problems with the authorities (Straussner, 2012). I was also unable to verify that drug abuse has severe implications and damaging impacts on the abuser’s relationship with his or her family.
Due to these assumptions and biases, the treatment process was shaped in a way that it addresses the wrong issues. To enhance the impact of the biasness of this treatment process, one has to give it the right approach. It is essential to approach the issue as a real problem and not as a particular case, which needs exaggerated attention. As a social worker, I have realized people are reluctant to respond to strangers. As a social worker, people view you as a minor health practitioner, and most of them doubt your ability to treat.
This compromises their willingness to share their personal information with you. On the other hand, the client feels threatened to give out his personal accounts on drug usage. To reduce the power differential effect as a social worker, I had to try to make the client feel comfortable to talk to me. I achieved this by holding private interviews to assure the clients of our conversation’s confidentiality.
Reference
Straussner, S. (2012). Ethnocultural factors in substance abuse treatment. New York, NY: Guilford Press.
