effective treatment and ethical considerations

Question 1

what are the principles of effective treatment

Answer 1

1. no single treatment is appropriate for all individuals
2. treatment needs to be readily available
3. effective treatment attends to multiple needs of the individual, not just his or her drug use
4. an individual treatment plan must be assessed continually and modified as necessary to ensure the plan meets the persons changing needs
5. remaining in treatment for an extended period of time
6. counselling/therapies are critical for effective treatment for addiction
7. medications are important, especially combined with counselling/therapy
8. clients with coexisting mental health and substance use should both be treated together
9. rehab is only the first step of treatment
10. treatment doesn’t need to be voluntary to be effective
11. possible drug use during treatment must be monitored continuously
12. treatment programs need to provide assessments for blood borne viruses
13. recovery can be a long term process and frequently requires multiple episodes of treatment

Question 2

what percentage of type 1 diabetes relapse

Answer 2

30-50%

Question 3

what percentage of hypertension relapses

Answer 3

50-70%

Question 4

what percentage of asthma relapse

Answer 4

50-70%

Question 5

what percentage of drug addicts relapse

Answer 5

40-60%

Question 6

what model do we use

Answer 6

the biopsychosocial model

Question 7

what are the overlapping variables in the biopsychosocial model of addiction

Answer 7

systems
social
psychological
biological

Question 8

what are the system variables in the biopsychosocial model of addiction

Answer 8

national/regional public policies
drug laws
socioeconomic context

Question 9

what are the social variables of biopsychosocial model of addiction

Answer 9

interpersonal relationships
treatment and drug use settings
social norms around use

Question 10

what are the psychological variables in biopsychosocial model of addiction

Answer 10

identity as a user
ability to cope
counselling and support services

Question 11

what are the biological variables of the biopsychosocial model of addiction

Answer 11

dopaminergic reward
hypothalamic, pituitary, adrenal axi (HPA) response
corticol response

Question 12

what are the components to comprehensive drug abuse treatment

Answer 12

child care services
vocational services 
mental health services 
medical services 
educational services 
AID/HIV services 
legal services 
financial services 
housing/transportation services 
family services

Question 13

what is project match

Answer 13

a study in the US over an 8 year in 30 locations, 130 clinical professionals and compared CBT, MI, 12 step programs and found that theyd all show similar findings/effect

Question 14

what are some criticisms for project match

Answer 14

eligibility criteria didn’t allow for polydrug use
too much focus put on assessment and follow up for research which interrupted usual therapy
all participants attended AA groups just the 12 step group went to more
abstinence was the only determinant of success
there was no control group

Question 15

what were the major conclusions from project match

Answer 15

that no superior treatment model exists
no single treatment intervention is effective for all people
matching treatment to clients is a complex but important process

Question 16

what are the 4 assumptions for informed eclecticism

Answer 16

there is no single superior approach to treatment
treatment programs/systems should be constructed with a variety of approaches that have been shown to be effective
different individuals respond best to different treatment approaches
it is possible to match clients to optimal treatment, therefore increasing treatment effectiveness and efficiency

Question 17

what is the Australian treatment outcomes study

Answer 17

Australian study on heroin users comparing replacement, withdrawal, residential rehabilitation and non-treatment control with 3 and 12 month follow ups
the treatment sample differed from gen. pop with more PTSD, depression, PD, and disability
high suicide and overdose rates as well as criminality

Question 18

what were the outcomes to ATOS

Answer 18

general functioning improved

majority of participants abstinent for the 1 month prior to 12 month follow up

Question 19

what was the percentage of improvement for replacement therapy in the ATOS

Answer 19

65%

Question 20

what was the improvement for residential rehabilitation in ATOS

Answer 20

63%

Question 21

what was the percentage of improvement in the ATOS for withdrawal

Answer 21

52%

Question 22

what was the percentage of improvement for non-treatment in ATOS

Answer 22

25%

Question 23

what was the most effective in the ATOS program

Answer 23

replacement therapy

Question 24

what else did they find in the ATOS

Answer 24

there was a noticeable reduction in criminal behaviour, improved related health and a decline in depression

Question 25

what drug has the highest treatment success

Answer 25

meth