The Opioid Epidemic is one of the major events that has occurred in the United States during the past few years. Several factors have contributed to this epidemic. Accrediting bodies identifying pain as the 5th Vital Sign certainly addressed patient’s pain but also accelerated the use of prescription narcotic pain medications as first line therapy rather than utilizing other types of pharmacologic agents that are not narcotics as well as trying other non-pharmacologic interventions such as holistic health modalities.
Dependent upon the type of narcotic pain medication prescribed, patients can develop a dependence upon the medication which then leads to addiction. Purchasing such medications can be rather expensive. Many patients then turn to purchasing less expensive drugs, such as Heroin, off of the street. Compounding the problem today is that much of the heroin is tainted with other drugs, such as Benzodiazepines and Fentanyl. Fentanyl is far more potent than heroin. The end result is that many young people as well as older people are dying from overdoses. If someone is not available to administer Naloxone immediately the end result is death.
There have been many strategies implemented by both the federal government and individual states governments to combat the opioid epidemic. Many states have implemented Prescription Drug Monitoring Programs (PDMP) that report the prescriptions for controlled substances that a patient purchases. Legislation has been passed to promote addiction treatment centers and medicated assisted treatment programs. Although there has been a noted decreased in opioid related deaths, there is still a long way to go to combat this epidemic.
Care rendered to the patient with opioid substance use disorders needs to be interprofessional and inclusive of Medicine, Nursing, Counseling and other behavioral modalities. Such interprofessional care will yield the best treatment outcomes.
Author(s): Albert Anthony Rundio, Stephanie Brooks
Series: Substance Abuse Assessment, Interventions and Treatment
Publisher: Nova Science Publishers
Year: 2020
Language: English
Pages: 267
Contents
Preface
Chapter 1
The Opioid Epidemic/SUD: Facts, Figures and Assessment Tools
Abstract
SBIRT (Screening Brief Intervention Referral to Treatment)
Case Example
Tools
Screening for Alcohol Problems
At-Risk Drinking
A. WHO - ASSIST V3.0
B. Who Assist V3.0 Response Card for Patients
C. Alcohol, Smoking and Substance Involvement Screening Test (Who Assist V3.0) Feedback Report Card For Patients
D. WHO Risks of Injecting Card – Information for clients
E. Translation and Adaptation to Local Languages and Culture: A Resource for Clinicians and Researchers
CAGE Questionnaire
Scoring
Clinical Opiate Withdrawal Scale (COWS)
Flow-Sheet for Measuring Symptoms for Opiate Withdrawals over a Period of Time
CRAFFT
Objective Opioid Withdrawal Scale (OOWS)
References
Chapter 2
The Neurobiology of Opioid Drug Addiction
Abstract
Case Study
Introduction and Overview
The Physiology of Addiction
Biologic Models of Addiction
Tolerance and Reverse Tolerance
Case Study Revisited
References
Chapter 3
Pharmacologic Concepts in Opioid Addiction Treatment Through the Continuum
Abstract
Pharmacokinetics and Pharmacodynamics
Case Study – Part 1
Treatment of Opioid Overdose
Case Study – Part 2
Withdrawal Management from Opioid Drugs
A Short History of the Detoxification Process
Case Study – Part 3
The Protracted Abstinence Syndrome
Case Study – Part 4
Medication Assisted Treatment
Medications Used in Maintenance Treatment of Opioid Use Disorder
Naltrexone
Methadone
Buprenorphine
Case Study – Epilogue
References
Chapter 4
Maternal Substance Use: Systemically Understanding Treatment and Recovery
Abstract
Introduction
Key Concepts in Maternal Substance Use
Prevalence and Correlates of Maternal Substance Use
Considering the Family Unit
Treatment Barriers for Maternal SUD
Cultural and Social Justice Considerations
Gender
Race and Ethnicity
Considering Intersectionality
Best Practices for Assessing and Treating Maternal Substance Use
Screening and Assessment
AUDIT
ASSIST
CAGE and CAGE-AID
Toxicology Testing
Evidence-Based Practices
Family-Centered Treatment
Trauma-Informed Care
Parenting Education & SUDs
Family Spirit Model (Center for American Indian Health at the Bloomberg School of Public Health at Johns Hopkins University)
Celebrating Families! (National Association for Children of Addiction, 2007)
Trauma & SUDs
Helping Women Recover: A Program for Treatment Addiction, Special Criminal Justice Edition (HWR) (Covington, 2000)
Seeking Safety (Najavits, Weiss, Shaw, & Muenz, 1998)
Opioid Use Disorders
Limitations of Current Treatment Models for Maternal Substance Use
Case Example: Mary
Treatment Considerations for Mary
Future Directions
Conclusion
References
Chapter 5
Opiate/Heroin Use in Pregnancy
Abstract
Introduction/Overview
Assessment
Medication Assisted Treatment
Post Induction/Maintenance Pregnancy Care
Neonatal Opioid Withdrawal Syndrome and Neonatal Outcomes
Conclusion and Clinical Pearls
Best Practice Pearls
References
Chapter 6
Complementary and Integrative Therapies for the Treatment of Opioid Abuse Disorder
Abstract
Foundational Concepts in Complementary and Integrative Health
Mindfulness Meditation
Mindfulness Based Relapse Prevention (MBRP)
Meditation Oriented Recovery Enhancement (MORE)
Acupuncture
Auricular Acupuncture
Neurofeedback
Alpha-Theta Protocol
Low Energy Neurofeedback System (LENS)
Emotional Freedom Technique (EFT)
Yoga
Trauma Sensitive Yoga and Trauma Informed Yoga
Integrative Restorative Yoga (iRest)
Spirituality
Future Implications and Considerations
Conclusion
References
Chapter 7
Adolescent Substance Use
Abstract
Adolescent Substance Use Disorder
Overview of Trends
Trajectories
Risk and Protective Factors
Treating Adolescent Substance Use Disorder
Access to Care
Assessment
Treatment
Therapeutic Approaches
Community-Oriented Programs
Pharmacotherapy
Contextualizing Treatment
Conclusion
Discussion Questions
Scenarios
Questions for the Scenarios
Screening Tools
CRAFT
CAGE-AID
Assessments
References
Chapter 8
Couple and Family Therapy Best Practices in Substance Use Disorders
Abstract
Introduction
Collaborative Care and Opioid Use Disorder
Why Collaborate?
Requiring versus Recommending
Myths and Realities of Collaboration
The Impact of Substance Use Disorder on Families
Carl’s Story
Key Issues Related to Treatment
Substance Use Disorder Systemic Metaframework for Assessment and Intervention
Culturally Informed Approach
Trauma Informed Approach
The Community Reinforcement and Family Training Approach (CRAFT)
Family Systems Perspective
Family Life Cycle
Genograms
Sample Questions for a SUD Focused Genograms are
Family Based Treatment Approaches
Functional Family Therapy
Multidimensional Family Therapy
Brief Strategic Family Therapy
Couple Therapy and SUD
The Russo’s Story
SUD Couple Therapy Approaches
Self of the Health Professional
Conclusion
References
Suggested Readings
Resources
Chapter 9
Understanding the Intersection between Trauma and Substance Use: Treatment Recommendations
Abstract
Trauma
Trauma and Substance Use
Trauma Informed Care Approach
Assessment
Treatment
Key Issues for Clinicians
Cultural and Social Justice Considerations
Case Example
References
Chapter 10
Drug Treatment Courts
Abstract
Introduction
Definition of Drug Treatment Courts
Origin of Drug Treatment Courts
Structure and Functioning of Drug Treatment Courts
Program Design and Implementation
Key Components
Episode of Care and Phases
Best Practices
Trauma Informed Care
Effectiveness of Drug Courts
Initiation of Drug Treatment Courts
Discussion Questions
References
Conclusion
Editor Contact Information
Index
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