Soc of Substance Abuse Final Exam

the concept of treatment assumes…

excessive substance use is ____

addiction is an ________

the problem can be _______

problematic, individual problem, corrected

early approaches to substance abuse treatment were_____

highly moralistic and condemning

19th century term for alcoholics

inebriates

what did they do in the 19th century to care for alcoholics?

institutionalized them

when was Alcoholic Anonymous founded?

1935

when was alcoholism conceptualized as a disease? by who?

1940s, Research Council on Problems of Alcohol at Yale

what was the result of conceptualizing alcoholism as a disease?

a profitable treatment industry

what did the Synanon drug treatment approach call for?

stay in a 24 hour environment insulated from outside influence

when was Synanon founded?

1948

when was Synanon shut down?

1989

now, drug addiction is considered….

a complex brain disease

the complex brain disease of drug addiction is characterized by…

compulsive drug craving, seeking, and use even in the face of adverse consequences

what is the ultimate goal of current drug treatment?

for the individual to achieve a lasting abstinence

what are some immediate goals of drug treatment?

to reduce drug abuse

improve ability to function

minimize medical and social impact of drug abuse

what frequently happens during drug treatment and is considered a part of recovery?

relapses

according to the National Institute of Drug Abuse, substance abuse costs US society ______ a year

$600 billion

is treatment cheaper than the cost of addiction for our health care and criminal justice system?

YES

programs designed to withdraw a person from dependency on drugs and stabilize their bodies

detoxification

drugs developed for the treatment of heroin addiction that do not produce dependence and block the euphoria of opioids

these drugs are for people who have successfully withdrawn and are not taking narcotics

narcotic antagonists, Vivitrol and Naltrexone

a substitute drug used to prevent the withdrawal symptoms

maintenance therapy

commonly used maintenance therapy drug for opioid addiction

methadone

a newer drug used for replacement therapy that functions like methadone, but has a much lower rate of abuse and overdose

suboxone

• used to treat pain, but lasts much longer than heroin (24 hours)

• supposedly less euphoric than heroin

• research indicates a decrease in crime among addicts on this therapy

• drug is very physically addictive — most people stay on it indefinitely

• people can and do get high off large doses

• about 5,000 overdose deaths a year in the US

characteristics of methadone

___% of the families involved in the child welfare system have problems that

are related to parental substance abuse

80

The recent epidemic of opioid abuse has resulted in an ______in drug-related parental referrals and placement of children in foster care

increase

In general, children whose parents abuse substances have higher rates of…

abuse and neglect, mental health problems, educational problems, behavioral problems

The majority of substance abusing parents ________ with treatment conditions set by the dependency court,

fail to comply

more than ____% of parents in the child welfare system don’t complete the mandated treatment

80

Compared to other families, the children of parents who are substance abusers stay in foster care _____ and the family has a ______likelihood of eventual reunification

longer, lower

Parents who abuse opioids are less likely to reunify with their children and are more likely to have their _________than parents who abuse other substances

parental rights terminated

requires a permanency decision by the court within twelve months of placing a child in foster care.

Adoption and Safe Families Act (1997) -

FDC parents tend to enter treatment ______and stay in treatment ______than parents who don’t participate

sooner, longer

Children from FDC families spend ______time in the child welfare system waiting for permanent placement than other children

less

FDCs are more _____ than other models of dealing with these problems

cost effective

Participants heroin addiction is absolutely overwhelming (brains are

essentially “_______”)

hijacked

who wrote about victimless crimes?

Edwin Schur

a term used to refer to actions that have been made illegal but which do not directly violate or threaten the rights of any other individual

These are crimes the lack a willing complainant

Also called vice crimes or public order crimes

Examples include drugs, prostitution, and gambling

victimless crimes

Although the illegal behavior underlying victimless crimes vary widely, they nonetheless share several characteristics:

willing parties, exchange of goods and services, no consensus on seriousness of offense

Participants do not view themselves as criminals

They are a source of pleasure and tremendous profits

Illegality adds to profits

Prime targets for organized crime

Enforcement of laws requires a different type of policing

Informants and undercover operations

Major area of graft and corruption in criminal justice system

Prime targets for “moral entrepreneurs” who see behavior as evidence of

declining morality

similarities between drugs and prostitution

those in which the buyer are seller are acquainted

Usually involves confidential informants, which is a person working for the

police to provide information, perform undercover "buys", and otherwise

implicate others in crimes (typically to reduce the penalty for an offense the CI is facing).

Their motive are impure – money or reduction of sentence

CI make terrible witnesses

discrete markets

are open-air, public drug markets

Typically involve undercover “buy and bust” operations

Can be very dangerous

non discrete markets

This seeks to “take the profits out of crime” and destroy the financial infrastructure of an organization. A popular strategy with some concerns

asset forfeiture

money and assets become more important than stopping

drugs

A famous observational study of a major city narcotics unit by Miller & Selva found that

agents were selective in their enforcement actions and seizing assets were more

important than taking drugs off the street

Extravagant purchases made with funds from forfeiture can “look bad” to the general

public

Concerns have been raised that the lure of asset forfeiture means some

departments neglect other crimes

profit motive

The vast majority of marijuana arrests are for

simple possession

the vast majority of people in prison for marijuana offenses were convicted of

distribution or sales

Those opposing legalization of marijuana argue that users must be arrested because….

it attacks the supply side

legalization would increase use

legalization would decrease moral standards

Prolegalizers of marijuana claim….

needless imprisonment of many people

sales from marijuana could benefit government

lifts all criminal and civil prohibitions against marijuana use

Marijuana is available in the market place

The state is literally “in the pot business”

legalization

removes or minimizes criminal sanctions

associated with a behavior

Typically involves possession related offenses

Users are not put in jail or given a criminal record

decriminalization

A recent Gallup poll found that nearly ___% of Americans are now in favor of legalizing marijuana

70

Surveys have been conducted since the ____, and the lowest point for support of legalization was ____, when only __% supported it

1960s, 1970, 12

_____is a major factor in predicting support of legalization of marijuana

Greatest support is among _____

Greatest opposition is among those ____

age, young adults, 65+

Arguments in favor keeping drugs illegal….

limits amount of users

protects both society and individual from harm

reinforces value of sobriety and self control

Arguments against keeping drugs illegal

costs

too much law enforcement infringes on civil rights

prohibition increases crime

corruption of police

public health problems

enforcement of drug laws cost tax payers about

_______a year

20 billion

Overall, __% of respondents to the 2025 poll support development of dispensaries with % oppose (Net Positivity +_).

47, 28, 19

there were net negative scores on the poll about support of marijuana dispensaries from…

republicans

those aged 65+

conservatives

Economic impact of marijuana dispensaries had a net positivity rating of +__

42

Quality-of-life for marijuana dispensaries – Net Positivity rating of +___

who rated this higher?

12, blacks hispanics and renters

Public Safety of marijuana dispensaries – Net NEGATIVITY -__.

7

Functions like methadone, but it has a much lower rate of abuse and

overdose

It is also easier to wean users of suboxone than methadone

It attaches to certain receptors in the brain thus blocking the euphoria from

another other opioid

Problems – drug is exceptionally expensive and tight controls mean very few

physicians are allowed to prescribe this drug

characteristics of suboxone

12-step groups are _____ oriented

spiritually

criticisms of 12 step groups

highly dogmatic

13th stepping

spiritual angle

veteran members of 12 step groups approaching new members for sex or dating

13th stepping

treatment philosophy mandates comprehensive lifestyle changes

Legitimate employment, healthy relationships, and avoiding crime

Group therapy and confrontation

Programs last approximately 12 months

treatment communities

– a comprehensive, shorter term approach to drug

addiction and especially alcohol

Based on 12-step model

After-care

minnesota model

challenges associated with substance abuse treatment

compulsory nature

community reintegration

gender issues

Data gathered from a variety of programs

Subjects were monitored for 12 years

Treatment reduced drug use and crime

Drug abuse reporting program

from the drug abuse reporting program, Only __% of subjects reported a continuous relapse of two years or more

41

Data from a variety of programs

All types of drug use decreased during and following treatment

Most significant drop was in those enrolled in residential treatment programs

Treatment Outcome Prospective Study

Prevalence of mental illnesses in the hardin county family drug court sample

77.6%

prevalence of mood disorders in the hardin county family drug court sample

69.4%

unemployment rate in the hardin county family drug court sample

80%