An In-Depth Look Into

Drug Addiction

Retrieved from: https://www.google.com/search?q

=drugs&biw=1366&bih=667&source
Retrieved from: https://www.google.com/search?q=
drugs&biw=1366&bih=667&source=

Retrieved from: ttps://www.google.com/ search?

q=drugs&biw=1366&bi

Presented by: Shantel Bishoff, Jerold Garrett, Joshua Hensley,

Ryan Hua, Emily Matthews, Gary Pearson, Jessica Scott, and Emily
Severance

Book Review - Junky

Written by William Burroughs in 1953
Autobiographical novel
Fictionalized experiences of using and
dealing drugs
Provides a vivid description of the
challenges faced by the author while
beginning drug use and attempting to
gain sobriety

(Retrieved from literaryfilm.wordpress.com)

(Burroughs, 1953)

What is addiction?
Addiction is repeated involvement with a substance or activity, despite the
substantial harm it now causes, because that involvement was (and may
continue to be) pleasurable and/or valuable.

Retieved from www.drugfreehomes.org

(American Society of Addiction Medicine, 2011)

Factors Involved in Addiction

Drug addiction shares many features with
chronic illnesses
Tendency to run in families (heritability)
Onset and course influenced by
environmental conditions and behavior
Ability to respond to appropriate
treatment, such as long-term lifestyle
modification

(National Institute on Drug Abuse, 2014)

Retrieved from :http://archives.drug

abuse.gov/about/welcome/aboutdrugabuse/chronicdisease/

Drug Addiction Video

https://www.youtube.com/watch?v
=P--6LEbksds

Retrieved from: http://www.blogging4jobs.com/wp-content/uploads/2013/06/drugs.jpg

National Statistics

Retrieved from http://www.drugabuse.gov/ publications

/drugfacts/treatment-statistics

9.2% of the population aged 12 and

older have used an illicit drug or
abused a psychotherapeutic
medication in the past month
Use of most drugs other than
marijuana has declined or remained
the same over the past decade

(National Institute on Drug Abuse, 2014)

Retrieved from http://www.drugabuse.gov/ publications

/drugfacts/treatment-statistics

Nevada Statistics
Drug-induced deaths are higher than national average
(515 deaths in 2011)
9% of Nevada residents reported illicit drug-use within the
last month with 4.5% of those being illicit drugs other
than marijuana

(Office of National Drug Control Policy, 2011)

Nevada Drug Trends

Nevada was one of the top 10 states for
rates in several drug use categories
o Past month illicit drug use among
persons age 12 and older
o Past year non-medical use of pain
relievers among 12 and older
o Past year non-medical use of pain
relievers among young adults 18-25

Retrieved from http://www.whitehouse.gov/sites /default/files/docs/stat

_nevada.pdf

(Office of National Drug Control Policy, 2011)

Treatment Options

Residential (inpatient) programs

Outpatient rehab programs
Group support or therapy sessions
Individual therapy with a board certified
substance abuse counselor
Medical intervention
(Recovery, 2015)

Treatment Options
Of the 23.5 million teenagers and adults addicted to
drugs only about 1 in 10 gets treatment
Only a small fraction of individuals receive interventions
or treatment consistent with scientific knowledge
Most treatment options are still utilizing outdated
methods dating back to the 1950s
Publicly funded clinics have better qualified therapists
and outcomes than the high-end residential centers
(Brody, 2013)

Drug Courts
A rehabilitation program used as an alternative to
prison in narcotics cases
The state of Nevada began using drug courts in 1992
Drug court allows individuals to participate in their
normal daily routines rather than being incarcerated
Completion of drug court successfully results in
criminal charges being dismissed
(Huddleston, Marlow, & Casebolt, 2008)

Nevada Drug Courts

Attend an outpatient rehab and education treatment program
Counseling once or twice a week
Appear one time per week before the drug court judge to monitor
your progress and may decrease over time
Must stay off drugs and are subject to random drug testing
People with prior drug convictions, charged with selling or
distributing are ineligible for drug court

(Huddleston, Marlow, & Casebolt, 2008)

Withdrawal Symptoms

Every drug and individual presents with different withdrawal symptoms

Emotional withdrawal symptoms
o Anxiety
o Irritability
o Social isolation
o Depression
Physical withdrawal symptoms
o Sweating
o Racing heart
o Palpitations
o Muscle tension
o Difficulty breathing
o Tremors/shaking
o Nausea, vomiting, or diarrhea
Retrieved from https://www.google.com/search?q=withdrawal
Life Threatening withdrawal symptoms
o Seizures
o Heart attacks
o Strokes
o Hallucinations, delirium
(Addictions & Recovery, 2014)

Impact on Marginalization
Sociocultural

Retrieved from logo-kid.com

Gender
o Wilsnack and Beckman (1984) indicate that drugs may be used in an attempt to reduce
feelings of guilt, shame, anger, and loss of self-esteem. Younger victims may express
their inner turmoil through antisocial behavior, including illicit drug use. The pain and
low self-esteem resulting from sexual abuse may drive some women into overtly selfdestructive use of drugs. (Rubin et al., 1996)

After all of the abuse I experienced in romantic relationships, being raped when
I was 15 years old, being cheated on time and time again, the abuse builds up and
you will do anything to take the pain away even if just for a moment.
(Personal Communication, 2015)

Impact on Marginalization
Sociocultural
o
o
o

Women are more likely to relapse when their romantic partners are substance users
Men-social, behavioral; Women- psychological
Men are more likely to abuse drugs than women, but also more likely to seek help

(Rubin
et al., 1996)
When I admitted myself I lost all custody of my kids to my
ex-husband
who also
was a drug addict. I never had the means to take care of my kids.I knew I was at
my breaking point and I knew I needed to be there for my kids-sober.

(Personal Communication, 2015)

Impact on Marginalization
Age
o

25% of Americans who began using any addictive substance before age 18 are addicted,
compared with 1 in 25 Americans who started using an addictive substance when they
were 21 or older (National Institute on Drug Abuse, 2014)

I
I
I
I

started using when I was 13 or 14.

have been using addicting drugs since I was 13 (marijuana and alcohol primarily)....
started using drugs when I was 16.
started using drugs when I was 19 years old

(Personal Communication, 2015)

Retrieved from drugfreepa.org

Impact on Marginalization
Sociocultural

Rituals/Religion
o Frat parties, Irish wakes, wine at mealtime for French and Italians and Jewish religious
observances
Geographic locations
o 11.8% in the West
o 9.2% in the Northeast
o 8.7% in the Midwest
o 8.3% in the South
o Cultural patterns
Studies consistently have shown that acculturation is positively correlated with
consumption of greater quantities and higher rates of drug abuse among
Hispanics/Latinas
Among Native Americans, the rate of current illicit drug use (12.6 %) is higher than any
other race or ethnicity in United States according to the NSDUH
These variables play an essential role in differentiating drug-use patterns, whether between ethno-racial
groups or within them

(National Institute on Drug Abuse, 2014)

Sociocultural Social Subcultures

What influenced your initial decision to experiment with drugs?

o

I was a dancer and I hung around a lot of artistry and free

spirited types of people and it seemed that it provided them a
relief from stress. Also I know of friends who experimented
with drugs.

Retrieved from wjosephedwards.com

When I started dating, the men I dated provided the pills like black cadillacs and pink hearts
(speed). We would all get together after school and head up to the mountains and they would
have a big mirror out on the table of their camp trailer and it would be a huge line of cocaine
and they would tell me to take a line. That was what we did for our hang outs after school, it
was just what we did...

The initial influence was my friends; they were doing it so I thought I would try it too.

(Personal Communication, 2015)

Impact on Marginalization
Socioeconomic
Socioeconomic status (SES) can greatly influence an individuals drug addiction. Many assume that
those in lower SES brackets are more inclined to abuse drugs, but thats not always the case. Social
status influences what types of drugs people use and how they obtain them, but addiction is an
issue at every social level.
Poverty/homelessness
Health literacy
Limited job opportunities
Education
High availability of drugs
Stresses of a metropolitan or urban lifestyle

(Galea & Vlahov, 2002)

Retrieved from http://www.sas.upenn.edu/~mfa

rah/research/socioeconomic-status-and-brain/

Socioeconomic Status
LOW SES:

Illegal street drugs, cigarettes and alcohol

Peer pressure and family history

Children of drug abuse homes more likely to experiment

Single parents, a parent working two jobs or parents who are not available for other reasons will not be as involved in their
childrens lives
o
US consumes more than 60 percent of the worlds illegal drugs, and much of the illegal drug activity can be found in the
inner-cities or lower socioeconomic areas
o
Ease of availability

MIDDLE SES:

More likely to have health insurance and access to prescription drugs

Prescription painkillers may be readily available

UPPER SES:

Greater access to both prescription and illegal drugs since cost is not an issue

Dangerous levels of recreational use, as frequent party goers experiment with lethal combinations to produce highs

Easy access and closer friendships with personal doctors or those medical licenses.

(Galea & Vlahov, 2002)

Socioeconomic Status
Retrieved from http://galleryhip.com/drug How did you financially afford your drug habit?
dealers-money.html
o Towards the end I was doing sexual favors with older men to get the pain pills. When I

o
o

didnt want to do it anymore the guy started threatening my children if I did not
continue to do the sexual favors. At the end I started stealing them so I didnt have to
do things with him. I was disgusted with what I was doing and had to find a different
way to get my pills.
Once I started using drugs regularly I could not support my habit, so I started dealing
drugs to have the finances to continue buying my own.
The American upper-middle-class citizen is a composite of negatives. He is largely
delineated by what he is not. p. 44 (Burroughs, 1953)

(Personal Communication, 2015)

Impact on Marginalization
Diversity
o The differences among groups of people and individuals based on
ethnicity, race, socioeconomic status, gender, exceptionalities,
language, religion, sexual orientation, and geographical areas.
It is becoming increasingly recognized that drug use and the dependence
of the illicit drug is a response to many factors in diverse populations.
Understanding the group differences across populations is critical to
creating and implementing effective intervention plans and referring the
clients to the proper substance abuse treatment programs.
(National Standard of Excellence in Teacher Preparation, 2014)

Impact on Marginalization
Percentages of illicit drug use based on race:
Asian 3.7%
Whites 9.2%
Pacific Islander 7.8%
Blacks 11.3%
Hispanics 8.3%
American Indians 12.7%

Retrieved from: http://www.americanbar.org/content/dam/aba/i

mages/international_law/spif_diversity2.jpg

(Substance Abuse and Mental Health Services Administration, 2012)

Impact on Marginalization
Pregnant women
Retrieved from: http://www.thefix.com/sites
/default/files/styles/article/public/heroin
Heroin
%20pregnant.jpg?itok=23Miy411
Mothers who inject narcotics are more susceptible to HIV, which
can be passed to their unborn children.
Heroin is a very addictive drug that crosses the placenta to the
baby. Because this drug is so addictive, the unborn baby can
become dependent on the drug.
Law
Some states, which includes Nevada considers prenatal
substance abuse as part of their child welfare laws. Therefore,
prenatal drug exposure can provide grounds for terminating
parental rights because of child abuse or neglect.
(American Pregnancy Association, 2012)

Impact on Marginalization
Youths in Foster Care
o 56% of the youths in foster care reported using street drugs, which is
at much higher rate than the overall population of high school
students. These youths also tend to continue their drug use after
leaving care. The drug addictions of youths in foster care can
severely hinder their chances of continuing their education or
finding employment. (The Impact of Substance Abuse on Foster Care, 1999)
LGBT
o Research indicates that, when compared with the heterosexual
population, LGBT individuals are more likely to abuse drugs. This
population is reported to have higher rates of substance abuse and is
less likely to refrain from drug use. (Gay and Bisexual Men's Health, 2013)

Lifestyle Choices
No single factor can predict whether a
person will become addicted to drugs
Risk for addiction is influenced by a
combination of factors that include:
o Individual biology
o Social environment
o Age
The more risk factors an individual has, the
greater the chance that taking drugs can
lead to addiction

Retrieved from: http://www.stuartmcmillen.com /wpcontent/uploads/2013/05/2013-05-Rat-Park-09-820-Rat-Parkresearchers-morphine-needle-01.png

(National Institute on Drug Abuse, 2012)

Lifestyle Choices
Burroughs, the main character of the book came from a Harvard
education, a relative carefree lifestyle, and a wealthy family; whom he
receives a monthly allowance from a trust fund. It was his choice to
begin using drugs, which in turn completely changed his lifestyle.
Why does an individual choose to become an addict?:
o The answer is that he usually does not intend to become an addict.You dont wake up
o

one morning and decide to be a drug addict. p. 4

You become a narcotics addict because you do not have strong motivations in any
other direction. Junky wins by default. I tried it as a matter of curiosity. p. 5

(Burroughs, 1953)

Lifestyle Choices
What influenced your initial decision to experiment with drugs?:
o Mainly curiosity, but I remember being influenced by friends at least in some way. A

lot of people that were using during that time were considered to be cool and in some
ways I think that I wanted to fit in.

(Personal Communication, 2015)

Lifestyle Choices
What was your aha moment to seek help/get clean?:
o My life was pretty much destroyed, and I could not live that way. I had to give it up.
o I finally realized if I didnt get my act together at that point then I never would. No
job, no money, no car, no place to live and all I could think about was how I was going
to get my next fix I didnt want this for myself anymore.

Retrieved from: tp://media.recovery.org/wp-content/uploads/addiction-recovery.jpg

(Personal Communication, 2015)

Lifestyle Choices
When you give up junk, you give up a way of life. I have seen junkies kick
and hit the lush and wind up dead in a few years. Suicide is frequent among
ex-junkies. Why does a junkie quit junk of his own will? You never know the
answer to that question. No conscious tabulation of the disadvantages and
horrors of junk gives you the emotional drive to kick. The decision to quit
junk is a cellular decision, and once you have decided to quit you cannot go
back to junk permanently any more than you could stay away from it before.
Like a man who has been away a long time, you see things different when
you return from junk. p.149

(Burroughs, 1953)

Population Beliefs
Drug addicts are viewed as burdens to society
Health- 14% of patients admitted to hospitals have alcohol/drug abuse and
addiction disorders. Almost 20% of all Medicaid hospital costs and nearly $1 of
every $4 Medicare spends on inpatient care is associated with substance abuse.
Crime- The connection between drug use and crime is well documented.
Loss in Productivity- 70% of individuals in state prisons and jails have used illegal
drugs regularly. Drug offenders account for more than 1/3 of the growth in state
prison population and more than 80% of the increase in the number of prison
inmates since 1985.
Economically- The economic burden in the United States for addiction is twice
that of any other disease affecting the brain, including Parkinsons and Alzheimers
Disease, as well as all the others.
(College of Problems of Drug Dependence, 2008)

Drug Abuse and Health

Many Americans perceive drug abuse as a major public health problem

Retrieved from Harvard School of Public Health et al., 2000

Population Beliefs
Many of America's top medical problems can be directly linked to drug abuse:
o HIV/AIDS: Approximately 1/3 of AIDS cases reported in 2000 (11,635) and
most cases of hepatitis C (approximately 25,000 in 2001) in the United
States are associated with injection drug use
o Approximately of pediatric AIDS cases result from injection drug use
or sex with injection drug users by the child's mother

(College of Problems of Drug Dependence, 2008)

Population Beliefs
In a study by Lerner and Lyvers:
Retrieved from: https://www.google.com/search?q=galaxy
Psychedelic users scored significantly higher on mystical
beliefs (e.g., oneness with God and the universe), life values
of spirituality, and concern for others
Psychedelic users also scored lower on the value of financial
prosperity, irrespective of culture of origin
Users of non psychedelic illegal drugs scored significantly
lower on a measure of coping ability
Both groups of illegal drug users scored significantly higher
on empathy than non illicit drug users
(Lerner & Lyvers, 2006)

Population Beliefs: Junky

According to Junky

Its a way of life

I have never regretted my experience with drugs. I think I am in better

health now as a result of using junk at intervals than I would be if I had
never been an addict. When you stop growing you start dying. An addict
never stops growing. Most users periodically kick the habit, which involves
shrinking of the organism and replacement of the junk-dependent cells. A
user is in continual state of shrinking and growing in his daily cycle of shotneeded for shot completed.

A junky runs on junk time. When the junk is cut off, the clock runs down
and stops. All he can do is hang on and wait for non-junky time to start. A
sick junky has no escape from external time, no place to go. He can only
wait.

Retrived from www.galleryhip.com

(Burroughs, 1953)

Population Values: Junky

According to Junky:

The next high

Where/How to obtain drugs
Staying out of prison
Values tend to change in proportion to
sobriety

Retrieved from: https://www.google.com/search?q=drugs&biw=

(Burroughs, 1953)

Population Values
According to Interviews:
Staying clean
Avoiding triggers
Maintaining positive relationships
Keeping in touch with support systems

(Personal Communication, 2015)

Population Roles
According to Interviews:
Odd jobs/Stealing
Do what you need to in order to
stay high
Laws and societal expectations
are negotiable
Lying and keeping secrets from
those that disapproved
Retrieved from ttps://www.google.com/search ?
q=drugs&es_sm=93&source

(Personal Communication, 2015)

Population Roles: Junky

According to Junky:
Main character was a father and husband
Other characters were functional drug users who held
jobs
Many characters in the book were drug users who sold
drugs, panhandled, prostituted, or performed odd jobs
to support their habit.

Retrived from www.realitystudio.com

(Burroughs, 1953)

Population Customary Practice

According to Interviews:
Frequently seeking more
drugs
Not engaging in many
meaningful activities while
high
Lying and stealing from loved
ones
(Personal Communication, 2015)

Population Customary Practice: Junky

According to Junky:
Drugs were socially acceptable in circle of friends
Location varied
Selling drugs became an easy way to keep up the habit
,Drug users usually participate in activities that give
them access to drugs

(Burroughs, 1953)

Effects on Health, Well-being &

Occupational Engagement
Health
o
o
o
o
o
o
o

Cardiovascular disease
Stroke
Cancer
HIV/AIDS
Hepatitis B and C
Lung disease
Mental disorder

Effects on Health, Well-being &

Occupational Engagement

Occupational Engagement
o Decreased ADLs
Bathing, personal hygiene, and grooming
I also stopped bathing. When you use junk the feel of water on the
skin is unpleasant for some reason and junkies are reluctant to take a
bath. (Burroughs, 1953)
o Decreased IADLs
Care of others and child rearing
Well I got a divorce from my husband. I lost friend and family
relationships. (Personal communication, 2015)
Financial and home management
I owed my friend/drug dealer over $5,000 and my roommates had to
cover 4 months of rent for me and I maxed out three credit cards for a
total of $9,000 in credit card debt with 29.9% interest. (Personal
communication, 2015)

Effects on Health, Well-being & Occupational

Engagement
Occupational Engagement Cont.
o Decreased leisure
When I was on drugs I could not leave the couch and when I
was not on drugs I could not leave the bed.
(Personal communication, 2015)

o Decreased job performance

My addiction also closed some doors for me professionally as I
was on track to being a professional goalkeeper.
(Personal communication, 2015)

o Increased social isolation

I stopped talking to my best friend and I lost my boyfriend.
(Personal communication, 2015)

Effects on Health, Well-being &

Occupational Engagement
Well-being: a state characterized by health, happiness,
and prosperity.
False sense of happiness when using drugs
Financial issues of using drugs
The effects of drugs on relationships

(Merriam-Webster, 2015)

Occupational Injustice
There are five forms of occupational injustice
1. Occupational Apartheid
2. Occupational Deprivation
3. Occupational Marginalization
4. Occupational Alienation
5. Occupational Imbalance

(Durocher, Gibson, & Rappaport, 2013)

Interview Process
6 Interviews administered, out of which:
Phone: 4
Email: 1
Person: 1
Interviewee Characteristics:
Sex
o Female-2
o Male-4
Age (started using drugs)
o 18-25- 5
o 26-35- 1
Race
o Caucasian-5
o African American-1

Age (interviewed)
o 18-25-1
o 26-35-1
o 36-45-1
o 46-55-1
o 56-65-1
o 66-75-1
Geographical demographics
o
o
o
o

West-4
Northeast-0
Midwest-1
South-1

Socioeconomic Status
o Low SES-2
o Middle SES-3
o Upper SES-1

Interview Process
1.
2.
3.
4.
5.
6.
7.
8.
9.

What was/is your drug of choice?

When did you start to use addicting drugs? What age were you?
What influenced your initial decision to experiment with drugs?
Were you educated (formally/informally) on the risks and side effects of
drugs before using them?
How did you financially afford your drug habit?
What was the biggest consequence that came from using and being
addicted to drugs?
How did using drugs affect your relationships with your friends and
family?
What were/are your triggers to get high?
What activities did you participate in while high?

Interview Process
10. What was your aha moment to seek help/get clean?
11. How long did you use drugs before recognizing that they were a problem?
12. Did you experience withdrawal symptoms when trying to quit (if
applicable)?
13. Did the withdrawal symptoms you experienced (if applicable) change your
mind about stopping drugs?
14. What types of rehabilitation programs have you used (if any) and which
were most effective?
15. What/who was your support system when you were getting clean?
16. What were/are your motivators to stay clean?
17. What activities help you avoid drugs currently?
18. How long have you been sober?

Resources
Recovery.org
o Grupo Rio De Luz
o Stairway Club II
o Ayura Para Familiares De
Recovery Group Meetings
o NA/AA
Principles Before Personalities
Jaywalkers
Specific Group Speakers
Recovery Centers (in Las Vegas)
o Addiction Medicine
o Las Vegas Recovery Center
www.region51na.org/

Questions?

Retrieved from: https://www.google.com/search?q=questions&es

References
Addictions and Recovery. (2014). Withdrawal. Retrieved from http://www.addictionsandrecovery.org/withdrawal.htm
American Pregnancy Association. (2012).Using Illegal Drugs During Pregnancy. Retrieved from
http://americanpregnancy.org/pregnancy-health/illegal-drugs-during-pregnancy/
Bradley, K.A.; Badrinath, S.; Bush, K.; et al. Medical risks for women who drink alcohol. Journal of General Internal
Medicine 13:627639, 1998. PMID: 9754520
Brody, J. E. (2013). Effective addiction treatment. The New York Times. Retrieved from
http://well.blogs.nytimes.com/2013/02/04/effective-addiction-treatment/
Burroughs, W. (1953) Junky. New York: Penguin books.
College of Problems on Drug Dependence (2008) Fact sheets. Retrived from http://www.cpdd.vcu.edu/

References
Galea, S., & Vlahov, D. (2002). Social determinants and the health of drug users; socioeconomic status,
homelessness, and incarceration. Public health reports, 117(Suppl 1), S135.
Gay and Bisexual Men's Health. (2013). Substance Abuse. Retrieved from
http://www.cdc.gov/msmhealth/substance-abuse.htm
Greenfield, S.F.; Hufford, M.R.; Vagge, L.M.; et al. The relationship of self-efficacy expectancies to relapse among
alcohol-dependent men and women: A prospective study. Journal of Studies on Alcohol 61:345351, 2000. PMID:
10757147
Fillmore, K.M.; Golding, J.M.; Leino, E.V.; et al. Patterns and trends in womens and mens drinking. In: Wilsnack,
R.W., and Wilsnack, S.C., eds. Gender and Alcohol: Individual and Social Perspectives. New Brunswick, NJ: Center
of Alcohol Studies, Rutgers University, 1997. pp. 2148
Huddleston, C., Marlowe, D., Casebolt, R. (2008). Painting the current picture: A national report card on drug courts
and other problem-solving court programs in the United States. National Drug Court Institute. 2(1), 1-28

References
Lerner, M., & Lyvers, M. (2006). Values and beliefs of psychedelic drug users: A cross-cultural study. Journal of
Psychoactive Drugs, 38(2), 143-147.
McKay, J.R.; Rutherford, M.J.; Cacciola, J.S.; et al. Gender differences in the relapse experiences of cocaine
patients. Journal of Nervous and Mental Disease 184:616622, 1996. PMID: 8917159
National Institute on Drug Abuse. (2014). Drug facts: Nationwide trends. Retrieved from
http://www.drugabuse.gov/publications/drugfacts/nationwide-trends
National Institute on Drug Abuse. (2012). DrugFacts: Understanding Drug Abuse and Addiction. Retrieved from
http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction
National Standard of Excellence in Teacher Preparation .(2014). Retrieved from
http://www.ncate.org/Standards/UnitStandards/Glossary/tabid/477/Default.aspx
Office of National Drug Control Policy. (2011). Nevada drug control update. Retrieved from
http://www.whitehouse.gov/sites/default/files/docs/state_profile_-_nevada.pdf

References
Recovery. (2015). Drug rehab treatment information. Retrieved from http://www.recovery.org/topics/about-rehaband-recovery/
Rubin, A.; Stout, R.L.; and Longabaugh, R. Gender differences in relapse situations. Addiction 91(Suppl.):S111S120,
1996. PMID: 8997785
Wilsnack, S. C., and L. J. Beckman. 1984. Alcohol Problems in Women: Antecedents, Consequences, and
Intervention. New York: Guilford.
Spark Action.(1999).The Impact of Substance Abuse on Foster Care. Retrieved from
http://sparkaction.org/content/impact-substance-abuse-foster-care#youths
Substance Abuse and Mental Health Services Administration. (2012). Results from the 2012 National Survey on Drug
Use and Health: Summary of National Findings. Retrieved from
http://media.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.pdf

Group Activity
Get into your book review groups
Read and discuss the following scenarios
within your group (make sure everyone
participates!), taking into account what you
would do as the OT practitioner in the
scene.
Present your findings to the class

Scenario #1
You are working with a client who has been recovering
from heroin addiction for just over six months. Before he
entered recovery, he used for ten years, almost everyday.
He is currently receiving outpatient therapy for an
unrelated matter. You have seen this client once per week
for the past four weeks without issue. All of a sudden, he
misses a treatment session without notifying the office.
What is your course of action and why?

Scenario #2
You are working with a client who suffers from chronic
back pain. You suspect that they are abusing their
prescription medication in an unauthorized manner. You
have some evidence to support your theory, but you are
overall unsure. What is your course of action and why?

Scenario #3
You are working in an acute care setting with a client who
actively uses (and admits to using) morphine as her
preferred drug of choice. She was admitted to the
hospital for chief complaints of shaking, cold sweats, and
discomfort. The client admits that she is experiencing
withdrawal symptoms involuntarily. You recognize the
opportunity for talking to this client about the risks of
drug use and encouraging her to quit. Explain how you
would go about this conversation and what the
conversation would include.

Scenario #4
You work in an inpatient rehab clinic. You suspect that an
attending physician (at your facility) is writing
prescriptions for chronic pain too generously. Many of your
patients receive prescriptions from this professional, and
you often think that the patients could benefit from other
treatment instead of prescription drugs. Explain your
specific course of action and reasoning for it.