Running head: ADDICTION COUNSELING 1
Addiction Counseling
Jennifer Walters
Liberty University HSCO 509
ADDICTION COUNSELING 2
Abstract
This paper reveals and examine first drug use in the society and its adverse effects. Most people
begin to experiment with illegal drugs in their early years. Some people may not resort to drug
use until later in life many times after experiencing trauma or crisis. This paper will demonstrate
different drugs types and their effects that they have on individuals. In America there are legal
and illegal drugs and this paper examines both. Substance abuse and substance use are two
different terms that the paper will explore. In the United States there has been an increasingly
number of deaths due to overdoses of both prescription and illegal drugs. Finally, the paper will
examine addictions intake process. There are different types of counseling and the intake
clinician determines which type of counseling the individual will need. Individuals also have
different programs that are available such as the 12 step Narcotics anonymous and Alcohol
Anonymous that both are designed to assist individuals in getting sober and the tools to stay
sober. The paper examines the process from inpatient and outpatient of the initial screenings to
treatment. Addiction counseling addresses different races, ages, genders, and socioeconomic
classes. Finally, the paper will address the spiritual; aspect to counseling along with ethical
expectations.
ADDICTION COUNSELING 3
Addiction Counseling
Addictions has been put on the forefront in America and the fight is getting larger. There was a
time when addiction was limited to drug use among the middle age and older population, the rich
and the poor. Presently, globally the world is dealing with addictions of all ages and genders. The
drug used are becoming more prevalent. Social media and the main stream media seem to be
popularizing certain drug use essentially making the fight even more difficult. This year alone
President Trump added to the fight prior to his election and allotted the states across America
heavy grants to fight the opioid crisis. Addiction is classified as any drug or alcohol that alters
your mood in any way. Addictions are not limited to street drugs, but addictions have
skyrocketed in the recent years from prescription drugs given legally. The world is witnessing
addictions as more and more deaths are attributed addictions each year and it seems to only be
getting worse. There are ways to fight addictions and there are rising with support groups,
outpatient clinics, and inpatient clinics counseling. Addiction counseling comes with its own set
of factors to consider. The ages, gender, drugs used, and spirituality and culture of the client. Inn
treating addictions there is no “cookie cutter” solution and every method does not work for every
individual. Research during this paper suggests that a person will relapse several times before
making the choice to choose sobriety. Also, counseling and support groups are more effective in
the long term than outpatient clinics.
Keywords: Substance abuse, Addictions, Sobriety, Groups, Prescription
Age Stages of Drug Use and abuse
Drug use has rapidly increased with a diversified group of ages. Even as early as
elementary schools there are early intervention programs. At different ages. Many factors
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influence whether an adolescent tries drugs, including the availability of drugs within the
neighborhood, community, and school and whether the adolescent’s friends are using them. The
family environment is also important: Violence, physical or emotional abuse, mental illness, or
drug use in the household increase the likelihood an adolescent will use drugs (NIDA, 2014). An
individual’s adolescent years are most important and the more negative factors the higher chance
of them becoming a drug user and abuser. The ore dysfunctional the family dynamics are will
subsequently lead to drug use or abuse in adolescence. Illicit drug use usually begins with
nicotine, marijuana or alcohol but not limited to these. Although the first contact with drugs can
occur at any stage of life, national and international studies indicate the onset of consumption
occurs mainly in adolescence, the transition phase between childhood and exposure to adulthood.
It is precisely during this period that hormonal, psychological and social changes take place
which impel the individual to begin to impose their personality and identification patterns
(Marina M. et at, 2017). A report surveyed displayed the use of these illicit drugs among
adolescents in the prior years were 5.8% among 8 , 9.4%, among 10 graders and 13.3%
th graders th
among 12 graders (NIDA, 2017).
th This survey was in the past 10 years. As time progresses
marijuana use, and alcohol are still the leading illicit drug experienced among adolescents. By
the time the students reach college drugs are reportedly the highest abuse at this level. During the
college years there is so much apprehension and tension dealing with the pressures of school and
grades. Also, being a first-year student in college for some it brings about a new change. They
are released from the confinements of home life with parents watching over them to a life of
freedom. They are quickly introduced to partying and drugs through social life. Social life in
college is usually when kids who have never tried any illegal or illicit drugs are more prone to
experiment.
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Types of Abused Drugs
Prescription drug abuse has reached an all time high peak in the United States. In 2012,
prescription drugs were second only to marijuana in prevalence of both illicit use and drug use
disorders (McHugh et.al, 2015). This has become one of the hardest epidemics to fight. Some
reasons that may contribute to this is that fact that some individuals masks the abuse behind
fabricated pain. Another reason that contributes to this epidemic is physicians are finding a way
to capitalize off many abusers and they utilize their license and practice as a “pill mill”. Daily
there are physicians that are being raided and arrested but is it enough? Some are reported to be
back up and running in no time. Therefore, some politicians have called for stricter punishment
when physicians violate their oath and misuse their license. The National Survey on Drug Use
and Health estimated that more than 16.7 million people ages 12 and older in the United States
abused prescription drugs in 2012, with approximately 2.1 million people meeting criteria for a
diagnosis of a substance use disorder related to prescription drugs. This reflects an increase of
250% in prescription drug abuse over the previous 20 years (McHugh et at, 2015). Therefore, as
statistics show prescription drug use is on steadily on the horizon with no relief in sight soon.
How can a friend or loved one notice if anyone around them are abusing prescription
medication? First off, if anyone is using medication for any reason other than what the doctor
prescribed he or she is abusing the medication. Individuals snort pills and they also steal other
prescriptions just to get high. This type of drug use is prevalent but not limited to the younger
generation.
The type of drugs abused the most are Opioids. Most doctors generally prescribe opioids
to treat pain. Some types of opioids include oxycodone and hydrocodone, alprazolam, diazepam,
hypnotics, and stimulants. These painkillers produce a euphoric feeling in individuals releasing
dopamine at a much faster rate in their brain. People may abuse opioids to relieve tension or
relax. Opioids when abused can cause slowed breathing, constipation, drowsiness, confusion,
poor eye or hand coordination, and nausea. Despite the risk factors it is not much of a deterrent
for individuals who have developed an addiction. They will resort to stealing and even killing if
it means that they will get their high. Another type of commonly abused prescription drug is drug
Alprazolam, known by its generic name Xanax. It is used for anxiety and people who suffer from
panic disorders. Xanax is snorted or taken orally. Either way the user is seeking the euphoric
feeling that follows the use of the drug. In some cases, individuals are prescribed Xanax but
continue to use the medication long after the disorder has been treated and they are no longer
showing symptoms. Ritalin which is prescribed to most patients suffering from ADD or ADHD
is another commonly abused opioids.
Among the common abused drugs alcohol is also is in that category. This category often
goes overlooked because many do not consider the devastating effects of alcohol mainly because
it is a legal drug like nicotine. However, anything rather it is legal or not has its boundaries that
can be crossed into addiction. In the past we have defined six or more standard drinks on a single
occasion as 'binge drinking, one could consider those who drink six or more standard drinks
'daily or almost daily' to have 'chronic excessive alcohol consumption (Harrison et at, 2016). In
the United States and other countries is very common for individuals to have dinner parties, to
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get together after work and have a few drinks, to have drinks when they get home. It is not taboo
but, in many countries, alcohol has become a way of life for many and they find themselves on
the other end of social drinking to binge drinking and abuse. Growing up with two parents that
were alcoholics, it is no walk in the park for the family and loves ones. Excessive alcohol
consumption kills approximately 75,000 people annually in the United States (Naimi T, 2016).
That is an alarming number considering that it is legal. It is the third leading cause of deaths in
the Unties States and alcohol was the determination for 75,000 deaths and 2.3 million years of
potential life lost in 2001 (Naimi, 2016). It is offered in almost every restaurant across the world
and here in the US it is reported that 30% of all alcohol drinkers are not social but excessive
drinkers (Naimi, 2016).
Street drugs are also a commonly abused drug. There has been a steady rise in the number
of synthetic and plant-based psychoactive substances, with an exponential growth in the
production and distribution of such drug (Lowe D.J, 2015,2017). With the popularity of street
drugs for quick profit comes high rates of crime. Gangs are often embattled over certain territory
were illicit drugs are being sold. Prostitutes are working to support their habits, and the local
street dealer has his or her mins set on getting rich. These drugs while may be on the street are
being transported by a much more powerful source like Columbian drug cartels or Mexican or
Cuban drug Lords. The street distribution is the lower level but behind the scenes a more
powerful principality is in charge. People are dying at alarming rates due to overdoses, drugs
being mixed together that are causing life threatening results. Street dugs unlike FDA approved
pharmaceuticals are being cooked and made by dealers who are trying to get their customer the
best high no matter the cost. Their idea is the keep the customer coming back to them as their
ingredient gives the best high. Law enforcement work around the clock, securing the border and
raiding local labs, however it still proves to mot be enough as these drugs are produced at mass
levels daily. Individuals have the slightest clue what some of these recreational drugs are made
of. Again, at the level of addiction their only concern is that they reach the desired effect.
Addiction s Counseling Assessments & Screening
Once these drugs cause a person to reach the level of addiction, some decide to seek help
while others ay be court ordered to do so. The first step in deciding what type of treatment will
be best is going through screening and assessment for addictions intake. The assessment tool is
determined by if the client is a substance abuser or substance dependent. The ASAM (American
Society Addiction Medicine) criteria is most widely used and comprehensive set of guidelines
for placement, continued stay and transfer/discharge of patients with addiction and co-occurring
conditions (Samet S., 2015). This is the most widely used model to assess addictions and their
placement. Screening is the formal process to first determine if the client is in fact in need of an
assessment for substance abuse disorder (not limited to). In this process the client is asked a
series of questions in which they may short answer or answer yes or no simply. In this process
ADDICTION COUNSELING 7
the counselor or intake staff is not trying to assess the problem nor identify what the issue may
be. In the screening process the intake officer does not even determine the seriousness of the
client at that time In substance abuse treatment or mental health service settings, every counselor
or clinician who conducts intake or assessment should be able to screen for the most common
screening and know how to implement the protocol for obtaining screening assessment
information and recommendations (CSAT, 2013).
Following the screening process is the determination rather an assessment needs to be
done. A basic assessment consists of gathering key information and engaging in a process with
the client that enables the counselor to understand the client's readiness for change, problem
areas, COD diagnosis, disabilities, and strengths. An assessment typically involves a clinical
examination of the functioning and well-being of the client and includes several tests and written
and oral exercises (CSAT, 2013). This is different from the screening as in the screening the
intake clinician is scanning for possible problems and possibly developing resources for the
client. In assessment the clinician is dealing with a specific problem. During the assessment
information is obtained such as family history and any trauma in the client’s life. It may also be
used to determine the background and depth of substance abuse such as the first time the client
used and if anyone else in the family may have a history of drug use or abuse. The assessment is
used to determine any past or current mental health issues as well in the client or his or her
family. All this information is very important to the clinician because this will determine the
level of care. As stated above the ASAM level of continuing determines where the client is in the
substance abuse or dependency.
ADDICTION COUNSELING 8
Support Groups
No matter what level of care a client falls under he or she may benefit from a support
group. Support groups are structured groups were members come together and bond. They all
share a common bond and they all have the same goal. They support one another by offering
testimonials and in some cases being sponsors for new comers. One of the oldest and the most
popular groups for addictions and alcohol is Narcotics Anonymous and Alcoholics Anonymous.
These groups once upon a time were one alliance however split up so that the members could
focus on their specific problem. Over the years the validity of NA and AA has been questioned as
to if they are effective or not. This is compared to maintenance treatment such as methadone and
other maintenance treatment. The groups basis for sobriety is abstinence. Studies have found
that, the people who seem to have less social support and suffer lack of multiple social supports
are more likely at risk to drug abuse. Discussion Interventions based on cognitive – behavioral
approaches, is effective treatment that it can alters behavioral and cognitive factors associated
with substance abuse and be as an efficient model for the prevention of drug abuse and after
treatment (Hashemi S.,2015). This may be accredited to the accountability and commitment
encouraged by support groups. Support groups are very assessable. They can be found all around
the globe. The times are flexible, and the groups are time conscious. The groups can be closed or
open. NA groups are open to everyone dealing with addictions while AA is strictly limited to
those dealing with or have dealt with an alcohol addiction. The groups are assembled and have
their own set of bylaws. They act in autonomy. The NA and AA groups are governed by the 12
-steps a guide and path to recovery. These groups consider themselves to be a fellowship. The
bonds among the clients are strong and each understand what it means to be addicted. Even
ADDICTION COUNSELING 9
though groups have had their share of criticism, they continue to be a front runner in assisting
individuals to maintain sobriety.
Cultural Counseling in Addictions
The development of effective treatments for African Americans and other ethnic
minorities is essential for reducing health disparities in substance use. Despite research
suggesting that Motivational Enhancement Therapy (MET) may reduce substance use among
African Americans, the findings have been inconsistent (Burlew A., 2013). In MET the goal is to
convince the person they need to make a change. In the African American community there is
much resistance to counseling and treatment. Some of the reasons may be due to generational
trauma or poor socioeconomic backgrounds. In poorer communities counseling for African
Americans is not as easily assessible as it would be in a white community. African Americans
have long must come up solutions on their own and unfortunately drugs have been the easiest
way to handle some of life’s issues. Most African American men fight against a racist system that
was designed for white American men. Most of them face some sort of prejudice daily. In their
communities there are disparities with resources and assistance. A white counselor may find
resistance to counseling an African American male because it is the assumption they do not
understand. African Americans are likely to witness illegal drugs sold in their community at
some point during adolescence. Most of the drugs sold in African American communities are
recreational street drugs that can be purchased cheap. When it comes to addictions with White
Americans, A study confirmed the idea that many heroin users start by using prescription opioids
like oxycodone and hydrocodone.
Approximately one-third of all white heroin users reported using prescription drugs for
non-medical purposes in 2001-2002. By 2013 more than half of all white heroin users started by
ADDICTION COUNSELING 10
initially using prescription drugs (Kounang N., 2017). White Americans have more choices
because of socioeconomic disparities among other races when it comes to addiction treatment.
They are less resistant to treatment. The drugs more commonly abused among white America are
prescription drugs, heroin, and powder cocaine.
Despite their growing numbers, Latinos fare worse in substance abuse treatment
programs—they have reduced access to these programs, worse participation, and lower retention
rates. This disparity is only worsened by the fact that one of every three Latinos lacks health
insurance, as compared to 11% of white non-Hispanics and 20% of Afro-Americans. The
Affordable Care Act is expected to increase health insurance coverage for at least six million
Latinos (Rojas J. 2014). Latino cultural characteristics may encourage the development of coping
practices such as avoidance, peritraumatic dissociation, and self-punitive coping (Rojas J., 2014).
Due to these cultural characteristics it may cause resistance and they may be reluctant to seek
help in addictions. In addition, this, some Latinos may be afraid of being deported (if they are
illegal).
Spiritual Beliefs & Addiction Counseling
Several studies suggest that the coping skills derived through religion and spirituality
may be an underutilized treatment resource (Heinz A., 2010). It is important for a clinician to
incorporate the clients spiritual beliefs (If any) in their treatment process. Most people who have
a spiritual connection are held accountable by a higher power. They have a strong sense of
loyalty to their higher power. Especially Christians. Levels of spirituality in individuals have
assisted individuals with the ability to remain in sobriety and less relapse.
Ethics and Addiction Counseling
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Ethics are generally regarded as the standards that govern the conduct of a person. Smith
and Hodges define ethics as a “human reflecting self-consciously on the act of being a moral
being. This implies a process of self-reflection and awareness of how to behave as a moral being.
Some definitions are dictated by law, individual belief systems, religion, or a mixture of all three
(Ethics Code, 2018). It is always the counselor’s responsibility to make sure that he or she is
acing in the best interest of is client. We are responsible for the client who puts his vulnerabilities
in our hands and trusts us to do our best. Ethics in counseling are important and necessary to
protect the client.
Closing
In closing addictions does not discriminate. It does not care what age, gender, race or
about our socioeconomic status. It comes like the spirit behind if from satan to kill, steal and
destroy. It is destroying the lives people through the stronghold of addictions. America has a long
fight ahead and globally we have just begun. Sanctions are going to have to be stricter on
physicians breaking oaths and the law must become more balanced when handing pout
punishment for the sale of illegal drugs. This epidemic is an ongoing fight and we must continue
to stay ahead of the enemy. As counselors we must be multiculturally trained to be able to assist
anyone in need and give them the best treatment possible. Also, it is imperative that we are
trained in trauma. At the root of most addictions lies unresolved trauma. We can do all things
through Christ Jesus who strengthens us, Ph 4:13 (NASB,2000).
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