2. ADDICTION Jean Sassatelli RN, MS Senior Director Behavioral Health Services Catholic Charities of Omaha

3. WHAT IS ADDICTION  When the use of alcohol and/or mood altering drugs causes problems in the individual’s family, social, work, school, legal, physical and/or emotional aspects of their life.

4. WHAT IS ADDICTION  Addiction is a pathological love relationship with a mood altering chemical, (or activity – i.e. gambling, sex, food). (McAuliffes’ Essentials of Chemical Dependency)

5. BEHAVIORAL SIGNS ADDICTION Change in attitude/personality for no identifiable reason. Change in friends, new hangouts Decreased performance at school, work and/or home. Change in activities or hobbies Change in habits at home Loss of interest in family and family activities

6. BEHAVIORAL SIGNS ADDICTION Forgetfulness and difficulty paying attention Lack of motivation, energy, self- esteem… ‘I don’t care’ attitude Sudden over sensitivity, temper tantrums Moodiness, irritability, or nervousness Silliness or giddiness Paranoia

7. BEHAVIORAL SIGNS ADDICTION Excessive need for privacy Secretive or suspicious behavior Chronic dishonesty Unexplained need for money Change in personal grooming Sudden change in wardrobe, hairstyle, or jewelry

8. ADOLESCENT ADDICTION Usage by Youth in Grades 9 -12 Alcohol:82% Marijuana:31% Inhalants:13% Meth.: 8% Cocaine: 7% 1999 Youth Risk Behavior Survey of Nebraska

9. CURRENT TRENDS ADOLESCENT ADDICTION 26% of youth have their first drink of alcohol before the age of 13. 28% of all fatal alcohol related motor vehicle accidents involve youth between 15 –20. Alcohol is a major factor in 50% of all motor vehicle accidents, homicides, and suicides among youth.

10. ADOLESCENT ADDICTION Juvenile Justice Link  83 % of youth involved with the Juvenile Justice System have alcohol and drug use problems.  Inhalant Use is more common in this group…

11. Substance Abuse Prevalence Data Based on Nebraska 1999 Census NEEDLikely to Demand Services Likely to Demand Specialty Services ADULT: Mental Health (Unduplicated)%Number% Diagnosed Mental Disorders 83,39420%16,67937%6,171 Serious Mental Illness 12,04140%4,81650%2,408 Diagnosed SPMI 9,00970%6,30676%4,793 Disabled by SPMI 3,03290%2,72993%2,538 TOTAL ADULTS - MH 107,47628%30,09353.9%15,910 ADULT Substance Abuse 32,55520%6,51120%1,302 TOTAL Behavioral Health – Adults 140,03026.1%36,60447.7%17,212

12. Substance Abuse Prevalence Data Based on Nebraska 1999 Census ADULTS Co-Occurring MH & SA Estimated Need Co-Occurrence by Level of Mental Disorder % Likely to Demand Specialty Services Diagnosable Mental Disorder 83,39411.6% 9,67437%3,579 Serious Mental Illness 12,04119.3% 2,32450%1,162 SPMI 9,00925.9% 2,33376%1,773 Disable by SPMI 3,03233.3% 1,01093% 939 Total Co-Occurring MH/SA107,47614.3%15,34152.9%7,455 Estimated Region VI – Adults with Co-Occurring Disorders (38.8%) 41,701 5,952 2,893

13. ADDICTION Co-Occurring Disorders  Substance Abuse combined with Mental Illness, occurs in 70% of those addicted.  The presence of co-occurring disorders reduces the responsiveness to treatment.  There is serious risk of missing a co- occurring disorder because the symptoms are ‘masked’ by the substance use.

14. Homeless National:2,000,000 Nebraska: 9,280

15. Nebraska Homeless

16. FAMILY MATTERS The Effects of Addiction on the Family U.S. Dept. of Health & Human Services:  10 million untreated persons in 2000  3 million received treatment in 2000

17. Addiction is one of the families most guarded secrets. Co-Dependency: Condition characterized by preoccupation and extreme dependency (emotional, social & physical) on a person or object. This becomes pathological. FAMILY MATTERS The Effects of Addiction on the Family

18. FAMILY ROLES: Dependent Enabler Hero Scapegoat Lost Child Mascot FAMILY MATTERS The Effects of Addiction on the Family

19. FAMILY SYSTEMS: v All members assume specific roles & relate to each other in characteristic ways. v The roles that family members adopt & how they relate to each other operate according to “rules”. Roles and patterns constitute equilibrium. v Any shifts in family equilibrium will cause resistance & system will seek a return to equilibrium. v No matter how sick/abnormal it may appear, the established equilibrium represents the family’s attempt to minimize threat of pain & disruption

20. FAMILY MATTERS The Effects of Addiction on the Family THE FAMILY SECRET ? Family requires intervention… all have affected, all need treatment!

21. ADDICTION GRIEF REACTION Grief is at the core of the recovery process. Much like the death or ending of a long-term relationship, the addicted individual has a committed, love relationship with their chemical, person, thing, and the discontinuation of this relationship causes a significant and very real experience of loss.

22. ADDICTION 5 STAGES OF GRIEF Denial & Isolation Anger Bargaining Depression Acceptance

23. ADDICTION TREATMENT Philosophical Approach:  Holistic  Family Systems Oriented  Developmentally Based Treatment Components:  Comprehensive Assessment  Plan of treatment based on the development strengths and needs of the adolescent, as well as the family strengths and needs.

25. Crisis Services: Medically Monitored Detoxification Civil /Emergency Protective Custody Treatment Services: Outpatient Treatment Intensive Outpatient Short Term Residential Transitional Services: Intermediate Residential Halfway House Prevention & Education Services: Community Support Post Primary Group Correctional Services Alumni Association