University of Tennessee
College of Social Work

Substance Abuse

Social Work 564 - 78653

Summer 2007 – Mondays and Wednesdays (6:30 – 9:30)

Room 209 Henson Hall 

 
Course Description

This course is intended to prepare students to practice in the field of substance abuse treatment. The course will present an integrative biopsychosocial model for the understanding and treatment of substance abuse. Course content includes an overview of the history of substance abuse, a review of models of addiction, a multidimensional model of the addiction process, the physiological affects of commonly abused substances, assessment and diagnosis of substance abuse disorders, an examination of treatment effectiveness, and specific clinical skills and treatment strategies for individual adult clients, adolescents, and families.

Course Rationale

Substance abuse is epidemic at this time in our culture. Social workers, regardless of practice setting, encounter the individuals and systems impacted by substance abuse. In order to respond to the needs of individuals, families, groups, and communities effected by substance abuse it is essential that social workers understand the multi-causal nature of the phenomenon. This course is designed to provide students with the knowledge, skills, and sensitivity to practice in the area of substance abuse treatment.

Course Objectives

By the end of the course, students will have acquired the following knowledge and skills:

1. Understanding of the sociopolitical-history of substance abuse in the United States;

2.  Understanding of the physiological aspects of substance abuse, including overdose, craving, tolerance, withdrawal, and other adverse effects on health in relation to the treatment process;

3. Understanding of the etiology and epidemiology of substance abuse;

4. Understanding of the theories/models of evidence-based substance abuse treatment;

5. Becoming skillful in clinical assessment and diagnosis of substance abuse;

6. Understanding of treatment effectiveness for substance abuse;

7. Becoming skillful in ethical use of specific clinical skills and treatment strategies for individuals, groups, and families

8. Understanding of the special treatment needs of at-risk populations;

9. Understanding of the processes of recovery, relapse, and relapse prevention;

10.  To recognize policies and practices relevant to cultural diversity, gender differences and discrimination

Methods to Attain Objectives

The primary learning format will be lectures, classroom exercises, and activities, which involve all students as active learners. Class lectures and exercises are based on the understanding that readings assigned for that topic have been completed prior to class.

Paper

In this paper you are to examine an area of substance abuse treatment of interest to you. This is an opportunity to develop specialized knowledge about a particular area of substance abuse treatment. Topics might include, but are not limited to, the efficacy of partial hospitalization treatment, treatment of cocaine addicted mothers, outpatient treatment of adolescents, prison addiction treatment, or treatment of individuals with dual diagnoses. If you have questions about the paper or wish to discuss possible topics, please email me.

The paper should include the following:

1. a biopsychosocial description of the problem or population including recent research findings,

2. a discussion of the social impact of the problem or population (why is this population or problem important?),

3. a review of treatment methods with special attention paid to evidence-based practice methods,

Criteria for evaluation of papers will include clarity, organization, synthesis of material, and overall mastery of content. Organization of your paper can enhance your grade. Papers need a beginning, middle, and an end. Introduce your topic and outline what will be covered in the paper. Use subheadings to direct the reader in the body of the paper. Summarize your conclusions at the end.

The paper must be typed and there must be at least 12 non-Internet references. The paper should be in APA format. The length should be 14 -20 pages and it may be turned in any time. It must be submitted no later than July 4th. Papers should be submitted to the digital drop box of the Blackboard course site. 

Alternative Digital Project  - Motivational Interviewing

This project requires the production of a 10-15 minute digital video (on digital video tape or DVD) demonstrating specific Motivational Enhancement skills.  Students may work in teams of 2 or 3 members.  Ideally, the edited final cut of the video will show the interviewer (helper) and the "client" in a Motivational Interviewing role play and indicate with titles the Motivational Interviewing principles employed. For an example of such a project, click on MET Video at http://edtech.tennessee.edu/~dpatter2/MET/Start.htm.  All submissions will be considered for inclusion on this Motivational Interviewing web site.  Projects will be graded on the quality of the skills demonstrated and the overall quality of the digital project.

Alternative digital projects are welcomed, but should be presented to and discussed with me before you begin work on the project. 

Course Outline

Readings listed here are subject to change and addition until the first day of class.

6/4/2007 - Introduction/Course Overview/Historical Review of Addictions 

Historical Perspectives - Chapter 2 - Katherine van Wormer and Diane Rae Davis - Digital reserve

Historical and Social Context of Psychoactive Substance Use Disorders - Joseph Westermeyer  - Clinical Textbook of Addictive Disorders (2005). Blackboard Course Site - Documents

6/6/2007- Epidemiology and Etiological of Substance Abuse

Nationwide Trends

2005 Monitoring the Future Survey Shows Continued Decline in Drug Use by Students

http://www.drugabuse.gov/newsroom/05/NR12-19a.html

Epidemiology of Alcohol Problems in the United States

Etiology and Natural History of Alcoholism

Epidemiology of Drug Dependence - James C. Anthony 

6/11/2007 - Neurophysiology and Pharmacology of Substance Abuse

 The Neurobiology of Substance Dependence: Implications for Treatment, Kosten, George, & Kleber Clinical Textbook of Addictive Disorders (2005). Blackboard Course Site - Documents 

Alcohol and Its Effects on the Body - (Chapter 3) - Daniel Yalisove -Digital reserve

The Neurobiology of Drug Addiction - NIDA- Science of Drug Abuse and Addiction

http://www.drugabuse.gov/scienceofaddiction/brain.html

The Biological Basis of Addiction

Pharmacology (Chapter 4) Drug Use and Abuse (2004) Blackboard Course Site - Documents

6/13/2007 - Drugs of Abuse 

Health Effects of Specific Drugs - NIDA InfoFacts: Science-Based Facts on Drug Abuse and Addiction

• Cigarettes and Other Nicotine Products

• Club Drugs [Revised March 2005]

• Crack and Cocaine

• MDMA (Ecstasy) [Revised March 2005]

• Heroin

• Inhalants

• LSD

• Marijuana [Revised March 2004]

• Methamphetamine

• Pain Medications and Other Prescription Drugs [Revised February 2005]

• PCP

• Methylphenidate (Ritalin) [Revised March 2005]

• Rohypnol and GH

• Steroids (anabolic) [Revised March 2005]
  

• Commonly Abused Drugs - http://www.nida.nih.gov/DrugsofAbuse.html

6/18/2007 -  Evidence Based Substance Abuse Treatment

Research Refines Alcoholism Treatment Options 

 National Treatment Trends - NIDA, 2003

Motivation and Treatment Interventions

 Scientifically Based Approaches to Drug Addiction Treatment

• Relapse Prevention

• The Matrix Model

• Supportive-Expressive Psychotherapy

• Individualized Drug Counseling

• Motivational Enhancement Therapy

• Behavioral Therapy for Adolescents

• Multidimensional Family Therapy (MDFT) for Adolescents

• Multisystemic Therapy (MST)

• Combined Behavioral and Nicotine Replacement Therapy for Nicotine Addiction

• Community Reinforcement Approach (CRA) Plus Vouchers

• Voucher-Based Reinforcement Therapy in Methadone Maintenance Treatment

• Day Treatment with Abstinence Contingencies and Vouchers

6/20/2007 - Diagnosis, Assessment, and Treatment

Current methods of assessing substance use: A review of strengths, problems, and developments

Detoxification From Alcohol and Other Drugs

Criteria for Substance Dependence Diagnosis

Substance Use Screening & Assessment Instruments Database

Transtheoretical Model - Stages of Change

A 'Stage of Change' Approach to Helping Patients Change Behavior - American Family Physician (March 1, 2000)

Harm Reduction: A New Perspective on Substance Abuse Services - MacMaster (2004)- Blackboard Course Site - Documents

6/25/2007 - Motivational Interviewing

Enhancing Motivation for Change in Substance Abuse Treatment - SAMHSA/CSAT Treatment Improvement Protocols

Motivational Interviewing Digital Demonstration

6/27/2007 - Evidence-Based Substance Abuse Treatment Practices

SAMHSA's National Registry of Evidence-based Programs and Practices

SAMHSA/CSAT Treatment Improvement Protocols

Substance Abuse: Clinical Issues in Intensive Outpatient Treatment

Brief Interventions and Brief Therapies for Substance Abuse

Substance Abuse Treatment: Group Therapy

Cognitive Therapy - Beck, Liese, and Najavits, Clinical Textbook of Addictive Disorders (2005) Blackboard Course Site - Documents  

7/2/2007 -  Treatment of Special Populations

7/6/07 – Final Due

Alcoholics Anonymous. (1976).  Alcoholics anonymous, AA World Service: New York, NY.

Akers, R. L. (1992) Drugs, Alcohol, and Society. Belmont, CA: Wadsworth Publishing Co.

Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive Therapy of Substance Abuse. The Guilford Press: New York.

Booth, B. M. , Yates, W. R. , Petty, F. & Brown, K. (1991). Patient factors predicting early alcohol-related readmissions for alcoholics: role of alcoholism severity and psychiatric co-morbidity. Journal of Studies on Alcohol, 52(1), 37-43.

Des Jarlais, D. (1995).  Harm reduction: a framework for incorporating science into drug policy.  American journal of public health, 85, 10-12.

Drucker, E.  (1995).  Harm reduction: a public health strategy.  Current issues in public health, 1, 64-70.

Fishbein, D. H. & Pease, S. E. ( 1996) The Dynamics of Drug Abuse. Boston, MA: Allyn & Bacon.

Frances, R. J. (1988). Update on alcohol and drug disorder treatment. J Clin Psychiatry, 49 (9), 13-17.

Frances, R. J., Miller, S. I., & Mack, A. H. (2005). Clinical Textbook of Addictive Disorders, 3rd. Ed., New York: The Guilford Press.

GAP Committee. (1991). Substance abuse disorders: A psychiatric priority. Am J Psychiatry, 148 (10), 1291-1300.

Gerstein, D. R. (1994). Outcome research, drug abuse. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 45-64). Washington, DC: American Psychiatric Press, Inc.

Golden, S. J., Khantzian, E. J., & McAuliffe, W. E. (1994). Group therapy. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 303-314). Washington, DC: American Psychiatric Press, Inc.

Gomberg, E. S. L. (1993). Women and alcohol: Use and abuse. The Journal of Nervous and Mental Disease. 181, (4), 221-219.

Haaken, J. (1990). A critical analysis of the co-dependence construct. Psychiatry, 53, (November) 396-406.

Hester, R. K. (1994). Outcome research, alcoholism, In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 35-44). Washington, DC: American Psychiatric Press, Inc.

Hester, R. K. & Miller, W. R. (1995) Handbook of Alcoholism Treatment Approaches: Effective Alternatives, 2nd Ed.. Boston, MA: Allyn and Bacon.

Jenson, J. , Howard, M. O. & Yaffe, J. (in review). Treatment of adolescent substance abusers: issues for practice and research.

Kaminer, Y. (1994). Adolescent substance abuse. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 415-437). Washington, DC: American Psychiatric Press, Inc.

Kaufman, E. (1994). Family therapy: Other drugs. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 331- 349). Washington, DC: American Psychiatric Press, Inc.

Leccese, A. P. (1991). Drugs and Society: Behavioral Medicines and Abusable Drugs. Englewood Cliffs, NJ: Prentice-Hall.

McNeece, C. A. & DiNitto, D. M. (1994). Chemical Dependency: A systems approach. Englewood Cliffs, NJ: Prentice-Hall.

Miller, W. R. (1992). The effectiveness of treatment for substance abuse, Journal of Substance Abuse Treatment, 9, 93-102.

Miller, W., & Rollnick, S. (1991).  Motivational interviewing: Preparing people to change addictive behavior.  New York: Guilford Press.

Narcotics Anonymous. (1988). Narcotics anonymous. Van Nuys, CA: NA World Service Office.

Peele, S. (1989). Diseasing of America. Lexington, MA: Lexington Books.

Schonttenfeld, R. S., (1994). Assessment of the patient, In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 25-33). Washington, DC: American Psychiatric Press, Inc.

Steinglass, P. (1994). Family therapy: Alcohol. In M.G. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment. (pp. 315-329). Washington, DC: American Psychiatric Press, Inc.

Van Womer, K. & Davis, D. R. (2003). Addiction Treatment: A Strengths Perspective. Pacific Grove, CA: Brooks-Cole.

Yaffe, J. , Jenson, J. M. , & Howard, M. O. (in review). Gender differences in substance abuse: implications for treatment of women.

Yalisove, D. (2002). Introduction to Alcohol Research: Implications for Treatment, Prevention, and Policy. Boston: Allyn & Bacon.