Alcohol And Drug Treatment

Did you know that 70 percent of those incarcerated in state prisons and local jails have abused drugs regularly, compared with 9 percent of the general population? Would you like a workable, alternative to paying an arm and a leg to incarcerate them?

Here are some facts: Drug abuse is involved in more than half of all violent crimes and 70 percent of child abuse and neglect cases.

As an addictions therapist, I see what really works. I saw what didn't work for years, as a counselor working in our penal system. Sorry folks, but the “lock them up and throw away the key” approach may feel good to say, but it doesn't work, and it's expensive as hell. The estimated cost to society in 2002 was more than $180 billion and more than $105 billion was associated with drug-related crime.

Substance abuse treatment really does work. The Substance Abuse and Mental Health Services Administration reports that substance abuse treatment cuts drug use in half and criminal activity by as much as 80 percent. Now this might not mean much if drug or alcohol abuse has never touched your life or the life of a family member, but then again, you might have to be from another planet for this to be true. Down here, drug and alcohol abuse ruins lives by fragmenting our most basic unit of society, the family. It causes physical, emotional and sexual trauma on a daily basis. This is documented repeatedly by the assessment process.

So, if treatment is so successful, why have so many communities resisted offering comprehensive treatment programs? Well, for one, addiction is still seen by many as a behavioral defect that requires the individual to take personal responsibility.

Incarcerating an emotionally dysfunctional person isn't going to cure their emotional dysfunction. Treatment addresses these issues and the inappropriate coping skill of drug and alcohol use. Yes, drug and alcohol abuse is a coping skill for those lacking the tools to cope appropriately. Those who have felt the pain of physical, emotional and sexual abuse can identify with these words.

Why are our judicial and legislative personnel so addicted to incarceration? The only thing that appears to make sense is their desire to be re-elected, and the lock-them-up message is easy to communicate, playing on emotions, not logic.

Data shows it's less expensive to provide comprehensive treatment than to let individuals sit in our prisons and jails. Every dollar invested in treatment yields a return of $4 to $7 in reduced drug-related crimes.

A disease is a disease. Imagine telling the diabetic that he is responsible for curing his own disease, without the help of a professional. I've yet to see an addict who wanted to be addicted. I've yet to see one who expected compulsive or criminal behavior would ensue once they started to use.

I ask you to please call or write your senators and congressmen. Tell them in no uncertain terms how you feel about treatment over incarceration. For more information, please contact the National Institute on Drug Abuse.

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D.J. Diebold, CAC, LISAC

Acute Stress Disorder

Finding help quickly is a wise choice for individuals who have experienced a traumatic event. Most people will encounter a traumatic event in their lifetime and one fourth of these individuals will develop Acute Stress Disorder (Understanding Abnormal Behavior, p.158.) Acute Stress Disorder, also called ASD, demonstrates the development of characteristic anxiety, dissociative, and other symptoms that occurs within 1 month after exposure to an extreme traumatic stressor. This event usually involves a direct personal experience of an event and may have actual or threatened death or serious injury, or other threat to one’s physical integrity. Witnessing an event that involves death, injury, or a threat to the physical integrity of another person can also cause Acute Stress Disorder. Learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate is also another essential feature of Acute Stress Disorder. Individuals in combat situations, people who have been battered and/or sexually assaulted are all likely to experience Acute Stress Disorder. Rape is another ‘traumatic event” that can result in ASD. In one instance, 74% of the victims of rape met the criteria for ASD and 3 months later, 35% met the criteria for PTSD (Valentine, Foa, Riggs, Gershuny, 1996). Finding help is important as left unchecked, Acute Stress Disorder could progress to Post-Traumatic Stress Disorder. It is believed that some fragile individuals can suffer a trauma reaction by just witnessing a television image.

In the available studies, it has been found that from 14% to 33% of individuals who have been exposed to severe trauma have been found to have Acute Stress Disorder (DSM-IV-TR pg. 463). You may experience a feeling of hopelessness, or overwhelming despair in which case it is wise to consider whether or not you are depressed. Impulsivity and risk-taking behavior is often present after the trauma has been experienced. Because of some of the symptoms of Acute Stress Disorder, you may not even realize that you are experiencing a residual affect of the trauma; you may not want to talk about it to anyone. You may think you have processed the trauma, but, in reality, you may be unable to recognize that you do need professional help in working through the incident.

At least three of the following dissociative symptoms must be present while experiencing the traumatic event, or after the event:

• a subjective sense of numbing, detachment, or absence of emotional responsiveness;
• ‘being in a daze';
• derealization;
• depersonalization;
• or dissociative amnesia which is the inability to recall an important detail of the trauma.

Following the trauma, the traumatic event is persistently reexperienced and lasts for a minimum of 2 days and a maximum of 4 weeks after the traumatic event.

People who suffer from Acute Stress Disorder find it difficult to be emotionally responsive. They no longer find pleasure in activities they once enjoyed and often feel guilty about pursuing usual life tasks. It is difficult to concentrate when you are experiencing Acute Stress Disorder. You may even feel detached from your body, or think that your world is unreal or dreamlike. People often lose recollection of details surrounding the traumatic event which is called dissociative amnesia. Perhaps you are persistently reexperiencing the event through flashbacks, or dreams, or thoughts that recur. Maybe you avoid places or people or activities that remind you of the traumatic event. You might have difficulty sleeping, or concentrating, and you may be irritable or have an exaggerated startle response. There may be agitation or overactivity (a flight reaction of fugue). Sweating and flushing are often present and perhaps signs of panic anxiety may also be demonstrated.

Finding help is important as left unchecked, Acute Stress Disorder could progress to Post-Traumatic Stress Disorder. What is the difference between Acute Stress Disorder and PSTD? ASD differs in that there are more dissociative symptoms (numbing, reduced awareness, depersonalization, derealization, or amnesia). Acute Stress Disorder is the immediate reaction to trauma. If left untreated, it could develop into PTSD. Cognitive behavioral interventions have proven quite successful in the treatment of Acute Stress Disorder. Because there is no closure in a tragedy or traumatic event, a caring, trusted, and trained professional counselor is the best equipped individual to help a victim process the clinical symptoms and profound feelings of Acute Stress Disorder.

Kathleen R. Madison, MRC, CRC, LPCI