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Presented by Ashley Cole, MA Project LINK Case Manager Region Ten Community Services Board P ROJECT L INK T ECHNIQUES & T OOLS FOR S UBSTANCE A BUSE D.

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Presentation on theme: "Presented by Ashley Cole, MA Project LINK Case Manager Region Ten Community Services Board P ROJECT L INK T ECHNIQUES & T OOLS FOR S UBSTANCE A BUSE D."— Presentation transcript:

1 Presented by Ashley Cole, MA Project LINK Case Manager Region Ten Community Services Board P ROJECT L INK T ECHNIQUES & T OOLS FOR S UBSTANCE A BUSE D ETECTION

2 P ROJECT L INK S UBSTANCE A BUSE Screening Techniques I N CONDUCTING A SCREENING, THE JOB OF THE INTERVIEWER IS NOT TO DIAGNOSE AN ADDICTION PROBLEM, BUT TO : DETECT WARNING SIGNS HELP THE CLIENT UNDERSTAND THE RISKS ASSOCIATED WITH DRUG USE HELP CLIENTS ACCEPT FURTHER ASSISTANCE AS NECESSARY.

3 P ROJECT L INK S UBSTANCE A BUSE Screening Techniques(cont) NOTE: I T IS ESSENTIAL THAT THE CLIENT BE MADE TO FEEL AT EASE AND AS COMFORTABLE RESPONDING TO THE QUESTIONS AS POSSIBLE. I T IS USEFUL TO BEGIN ASKING ABOUT TOBACCO AND ALCOHOL AND THEN PRESCRIPTION DRUGS BEFORE MOVING ON TO THE ILLICIT DRUGS.

4 P ROJECT L INK S UBSTANCE A BUSE Screening Techniques(cont) S OME GENERAL GUIDELINES FOR INITIATING A DISCUSSION ABOUT SUBSTANCE USE ARE : D O SO ONLY IN THE CONTEXT OF A RELATIONSHIP BASED ON TRUST AND MUTUAL RESPECT. M ENTION THAT THE QUESTIONS ARE PART OF YOUR ROUTINE PROCEDURES. A SSURE CONFIDENTIALITY. I T MAY BE HELPFUL TO MENTION THAT IN V IRGINIA THE S OCIAL S ERVICES POLICY IS NOT TO REMOVE A CHILD FROM THE HOME SOLELY BECAUSE OF ALCOHOL OR OTHER DRUG USE BY A PARENT.

5 P ROJECT L INK S UBSTANCE A BUSE Screening Techniques(cont) M AINTAIN A POSITIVE ATTITUDE AND A RELAXED COMPOSURE. P ROMOTE AN ATMOSPHERE OF COOPERATION. B E ALERT TO CLUES IN A CLIENT S PHYSICAL, SOCIAL, EMPLOYMENT, OR FAMILY LIFE. R EMEMBER THAT THE USE OF ALCOHOL AND OTHER DRUGS OFTEN IMPACTS EVERY ASPECT OF A PERSON S LIFE. N OTICE CLIENT NONVERBAL CLUES : A N INABILITY TO ESTABLISH AND MAINTAIN EYE CONTACT, STRAINED FACIAL EXPRESSIONS, DROOPED POSTURE, AND ANXIOUS AND JITTERY MOVEMENTS CAN PROVIDE YOU WITH INFORMATION ABOUT A CLIENT S USE OF DRUGS

6 P ROJECT L INK S UBSTANCE A BUSE Screening Techniques(cont) A SK THE QUESTIONS NON - JUDGMENTALLY. B E SENSITIVE TO LEGAL IMPLICATIONS. G IVE THE CLIENT TIME TO RESPOND AND TO ASK QUESTIONS OF HER OWN. R EPEAT OR REPHRASE IF NECESSARY ; SUGGEST A POTENTIAL RANGE OF ANSWERS. A SK OPEN - ENDED QUESTIONS THAT DO NOT IMPLY ANY RIGHT ANSWER, OR GIVE AWAY YOUR OWN REACTIONS. L ET THE CLIENT KNOW THAT YOU APPRECIATE HER WILLINGNESS TO TAKE THE TIME TO RESPOND TO YOUR QUESTIONS. B E ALERT TO SIGNS, SYMPTOMS, AND PATTERNS THAT ARE HIGHLY CORRELATED WITH SUBSTANCE ABUSE.

7 P ROJECT L INK Indicators Correlated with Substance Abuse B EHAVIORAL P HYSICAL H ISTORICAL M EDICAL

8 P ROJECT L INK B EHAVIORAL Indicators H ISTORY OF CHILD ABUSE AND / OR NEGLECT I NCEST SURVIVOR H ISTORY OF SUICIDE ATTEMPTS, THOUGHTS, OR GESTURES C ITATIONS FOR DRIVING UNDER THE INFLUENCE H ISTORY OF DOMESTIC VIOLENCE C AR ACCIDENTS H ISTORY OF SUBSTANCE ABUSE IN FAMILY D EPRESSION E ATING DISORDER D IFFICULTY CONCENTRATING I RRITABILITY OR AGITATION I NCONSISTENT STORIES

9 P ROJECT L INK B EHAVIORAL Indicators W EIGHT LOSS I NAPPROPRIATE BEHAVIOR S MELL OF ALCOHOL ON BREATH U NRELIABLE / UNPREDICTABLE BEHAVIOR M ISSED APPOINTMENTS S LURRED OR STAGGERED SPEECH F AMILY C HAOS H ISTORY OF ABSENTEEISM C ONFLICTS WITH SIGNIFICANT OTHERS O NLY PRESENTS A VAGUE HISTORY OF PERSONAL / MEDICAL PROBLEMS U NEMPLOYMENT OR UNDEREMPLOYMENT

10 P ROJECT L INK B EHAVIORAL Indicators U NSTABLE LIVING CONDITIONS E RRATIC SCHOOL OR WORK HISTORY P ARTNERS WHO HAVE SUBSTANCE ABUSE PROBLEMS L ACK OF PRENATAL CARE / MEDICAL CARE O NE OR MORE CHILDREN WITH HISTORY OF DEVELOPMENTAL, BEHAVIORAL, AND / OR EMOTIONAL PROBLEMS C HILDREN IN FOSTER CARE SYSTEM P SYCHIATRIC TX AND / OR HOSPITAL ADMISSIONS FOR PSYCHIATRIC DISORDERS I NFANTS WITH LOW BIRTH WEIGHTS F REQUENT LAPSES OF MEMORY C HILD WHO DIED FROM SUDDEN INFANT DEATH SYNDROME

11 P ROJECT L INK P HYSICAL Indicators B ODY ODOR ( ALCOHOL, CHEMICALS, POOR HYGIENE ) N ASAL PROBLEMS ( SNIFFLING, RUNNY NOSE ) S KIN PALLOR B URNED FINGERS ( PARTICULARLY FINGERTIPS, HANDS ) B LOOD SPATTERS ON CLOTHING, FURNITURE, ETC. E XCESSIVE USE OF EYE DROPS E XCESSIVE USE OF BREATH MINTS B LOODSHOT OR GLASSY LOOKING EYES T EETH GRINDING D ILATED OR CONSTRUCTED PUPILS C UTS AND BRUISES D ENTAL ISSUES / BAD BREATH

12 P ROJECT L INK P HYSICAL Indicators N AUSEA & V OMITING S LURRED S PEECH L ACK O F C OORDINATION L OSS O F M OTOR C ONTROL N EEDLE M ARKS D RY M OUTH (F REQUENTLY L ICKING O F L IPS ) M ENTAL C ONFUSION D IZZINESS T REMORS U NKEMPT A PPEARANCE T ARDIVE D YSKINESIA

13 P ROJECT L INK H ISTORICAL Indicators A LCOHOL OR DRUG - USING PARTNER A LCOHOL OR DRUG - USING FAMILY OF ORIGIN M ULTIPLE EMERGENCY ROOM VISITS H IGHER THAN USUAL NUMBER OF PHYSICIAN VISITS C HILD WITH ALCOHOL / DRUG - RELATED BIRTH DEFECTS C HILD WITH HISTORY OF NEONATAL WITHDRAWAL SYNDROME P LACEMENT OF CHILD / CHILDREN OUTSIDE OF HOME C OMPLEX PERINATAL HISTORIES AND / OR OUTCOMES P SYCHIATRIC TREATMENT OR HOSPITAL ADMISSIONS A FFECTIVE DISORDERS I NFANTS WITH LOW BIRTH WEIGHTS C HILD WITH S UDDEN I NFANT D EATH S YNDROME H ISTORY OF DOMESTIC VIOLENCE

14 P ROJECT L INK H ISTORICAL Indicators I NCEST SURVIVOR U NSTABLE / UNSUITABLE LIVING CONDITIONS H OMELESSNESS C IGARETTE SMOKING DURING PREGNANCY P SYCHOLOGICAL ISSUES : POOR SELF - ESTEEM, DEPRESSION, GUILT, SHAME E RRATIC SCHOOL OR WORK HISTORY P OOR MEDICAL OR PRENATAL CARE H ISTORY OF CHILD ABUSE OR NEGLECT P REVIOUS / CURRENT SUICIDE ATTEMPTS C ITATIONS FOR DRIVING UNDER THE INFLUENCE P REVIOUS / CURRENT CRIMINAL ACTIVITY P ATTERN OF CAR ACCIDENTS

15 P ROJECT L INK M EDICAL Indicators L IVER DISEASE P ANCREATITIS H YPERTENSION N EUROLOGIC DISORDERS G ASTRITIS, ESOPHAGITIS P OOR NUTRITIONAL STATUS H EMATOLOGIC DISORDERS S EROPOSITIVITY FOR HIV F REQUENT BACTERIAL INFECTIONS A LCOHOLIC MYOPATHY S ENSORY IMPAIRMENT P ROBLEMS OF SEPSIS, CELLULITIS H EPATITIS A BSCESSES C UTS AND BRUISES S WELLING OF THE HANDS O VERDOSES W ITHDRAWAL EFFECTS P ULMONARY INFECTIONS H AIR LOSS E RRATIC MENSES P OOR DENTAL HYGIENE U NKEMPT APPEARANCE A NEMIA T UBERCULOSIS S EXUALLY TRANSMITTED DISEASES N O OR POOR PRENATAL CARE M ULTIPLE ABORTIONS ( SPONTANEOUS AND / OR ELECTIVE ) T ARDIVE D YSKINESIA

16 P ROJECT L INK S UBSTANCE U SE S CREENING I NSTRUMENTS R EMEMBER : Y OU ARE SCREENING, NOT DIAGNOSING !

17 P ROJECT L INK S UBSTANCE U SE S CREENING I NSTRUMENTS T HE FOLLOWING SCREENING INSTRUMENTS ARE : E ASY TO REMEMBER AND ADMINISTER T YPICALLY NON - THREATENING O FTEN VALUABLE IN OPENING UP DISCUSSION ABOUT ALCOHOL AND DRUG USE *THE 4 PS CAGE T-ACE * HTTP :// WWW. HEALTHRECOVERY. ORG

18 P ROJECT L INK S UBSTANCE U SE S CREENING I NSTRUMENTS D O YOU CONSIDER EITHER OR BOTH OF YOUR PARENTS TO BE AN ADDICT OR ALCOHOLIC ? D OES YOUR PARTNER HAVE A PROBLEM WITH DRUGS OR ALCOHOL ? H AVE YOU HAD A PROBLEM WITH DRUGS OR ALCOHOL IN THE PAST? A RE YOU PRESENTLY USING DRUGS OR ALCOHOL ? T HE 4 P S : A NY WOMAN WHO ANSWERS YES TO ONE OR MORE QUESTIONS SHOULD BE REFERRED FOR FURTHER ASSESSMENT.

19 P ROJECT L INK S UBSTANCE U SE S CREENING I NSTRUMENTS C – H AVE YOU EVER FELT THE NEED TO CUT DOWN ON YOUR DRINKING OR DRUGGING ? A – H AVE YOU EVER FELT ANNOYED BY OTHERS CRITICISM OF YOUR DRINKING OR DRUGGING ? G – H AVE YOU EVER FELT GUILTY ABOUT YOUR DRINKING OR DRUG USE ? E – H AVE YOU EVER HAD A MORNING EYE-OPENER TO COUNTER THE EFFECTS OF HANGOVER OR TO STEADY YOUR NERVES ? CAGE: I F A CLIENT ANSWERS YES TO TWO OR MORE OF THE FOLLOWING QUESTIONS, SHE SHOULD BE REFERRED FOR FURTHER ASSESSMENT.

20 P ROJECT L INK S UBSTANCE U SE S CREENING I NSTRUMENTS T – H OW MANY DRINKS OR HOW MANY DRUGS DOES IT TAKE YOU TO GET HIGH ? (TOLERANCE) A – H AVE PEOPLE ANNOYED YOU BY CRITICIZING YOUR DRINKING OR DRUGGING ? C – H AVE YOU EVER FELT YOU OUGHT TO CUT DOWN ON YOUR DRINKING OR DRUGGING ? E – H AVE YOU EVER HAD A DRINK OR DRUG FIRST THING IN THE MORNING AS AN EYE-OPENER OR TO STEADY YOUR NERVES ? T-ACE: I F A WOMAN WHO ANSWERS MORE THAN TWO DRINKS ON THE TOLERANCE QUESTION IS SCORED 2 POINTS. E ACH YES TO EACH OF THE ADDITIONAL THREE QUESTIONS GETS A SCORE OF 1. A SCORE OF 2 OR MORE IS CONSIDERED A POSITIVE SCREEN, AND THE WOMAN SHOULD BE REFERRED FOR FURTHER ASSESSMENT.


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