week 13 - specialist interventions Flashcards
what are the three broad catagories of intervention?
indivisual, environment and drug interventions
what is methadone treatment? what are the negatives/risks associated with this treatment? what are positivies?
- full opiate agonist - takes the place of heroin (similar to OH and benzodiapiene)
- only for people with VERY high maintainance/dependant
- useful for chronic pain treatment
- highly regulated - GP has to have specilised treatment/regulation to prescribe this
negatives: person has to take almost everyday to be able to function properly/avoid bad withdrawl
- ppl can still use heroin on top of methadone -> if high amounts taken -> very risky
- ppl choose to inject it instead of drinking
positives: high retention -> regular contact with treatment advisors/nurses
- reduces many of the problems seen with heroin use (blood bourne viruses - HEP C, HIV, criminal behaviour)
what is bupanorphine? what type of treatment is it? Outline some of the positives and negatives with this treatment
- partial agonist/antagonist to opiates - produce opiate like effect - if you take anything more (heroin) it will be blocked
- postitives:
- withdrawl is much less severe than withdrawls from methadone
- higher retention improves maintainence and reduces heroin use
- can be taken single/double/triple doses -> if triple taken you dont need to take it for another 3 days
negative: will not be effective for people who are HIGHLY dependant on opiates (heroin)
what are some anti-craving and antabuse medications in treating alcohol abuse?
anti-craving
- reduces OH craving
- Campral and Naltrexone
- both can be taken both at the same time
anabuse medications
- removes enzymes that break down alcohol
- when OH taken -> makes person VERY ill (becomes allergic to alcohol)
- creates positive punishment
negative: risk of develiping liver diseases (as it blocks liver enzyme) and HEP C
Does naltrexone work on alcohol the same way naltrexone works for opiate use?
- naltrexone blocks the receptors of opaites -> eliminates the effect of opiates
- > naltrexone DOES NOT do the same for OH but cravings of OH reduced because it removes some of the opiate - euphoric like feeling that opiate gives
what is urine drug screening used for?
- to identity whether or not person has consumed drug recently
negatives:
- can result in false postiives/negatives -> loose job/kids/relationships
- urine drug screening is seen as a “game” to many people and their primary goal is to BEAT a screen test and not focus on treatment goals
postitve:
if someone wants to show that they are capable of making a change and wants to prove to ppl -> good tool to use
what interventon would be good for poeple who dont want to give up drinking completely? (indivisual type of interevention - psychological treatments)
what are some problems?
controlled drinking training
- abstienance is not the goal - harm minimisation
- requires very high motivation - planning/goal setting
problems:
- ppl who have had previous problems with OH - having any at all can make it worse
according to controlled drinking/drug training what are some tips to give people to control their drinking?
- plan ahead
- consume OH with less OH
- dont drink cocktails
- start with non-alcoholic drink
- every second drink non-alcoholic
what is the self-help group appraoch? what is the most common treatment within self-group therapy? what are the positives and negatives with this type of therapy?
- primarily peer based - run by peers in recovery
- easy to run with very low cost
positive:
- widely available
- very low cost
- ppl who run it are under recovery themselves - they are really passionate and motivate others well -> people who are within the group feels comfortable
negative:
- some ppl fucking hate it
- very spiritual -> drives ppl notes
- people with religion problems will not like this
- require abstience as a goal
most common: AA - 12 step programs
what is a brief intervention?
- goal is to prevent the problem from happening
- targeted intervention for people who are at risk of alcohol abuse
- several meetings 1-5
- pervention - talk about strategies to prevent harmful drinking patterns
- NOT an option for people who already has a drinking problem
what is a social skills training?
- indivisual/psychological intervention
- idea that ppl developed OH issues due to their problems interacting/social skills
- ppl use OH to help socialise -> become dependant to socialise
- teach social skills -> take away reason to have OH
- teach assertiness, anger management, role playing,
what is cognitive behavioural therpy?
- focus on eliminating psychological distress and eliminating bad behaviour
- dysfunctional cognitions: “i need this to cope”
- improving behaviour: improve on how/who you interact with others
- client and therpist work as a team
- changing thoughts to change behaviour
- time-limited specific treatment
- focuss on dealing with cravings, moniotiring thoughts/patterns, alternative activities, goal setting
- CUES TO ACCOCIATION: smoking usually occuurs in car - conditioned to smoking in the car
problems:
- may be DD - person may not just come with one problem
why is considering the environment important in alcohol interventions?
- someone might be on track during treatment but if their environment is shit -> falls back down to where she started (partner is a dealer/parents are OH abusers)
what is community development? what type of intervention is it?
- environment based intervention
- focusses on dealing with the patients comunity and to ensure it is as safe/supportive as possible when the patient returns back to her environment
- raise awareness of drug issues
what happens in interventions that target employment/educational oppotunities
- recognises social disadvanate in alcohol users
- opportunity for patient to gain social network/social skills outside their drug using lifestyle
- serves as protective factor
- introduces alternatives/healthy lifestye
