Recovery Oriented Approach: Care of the patient with a substance use disorder

SECTION 2

PURPOSE: The care of patients with substance use disorders is crucial for addressing both the physical and psychological aspects of addiction. Providing compassionate and evidence-based care supports individuals in regaining control of their lives and achieving sustained recovery.

Additionally, effective care reduces healthcare system burdens by preventing relapse and minimizing healthcare utilization. By adopting a holistic approach, healthcare providers can address underlying issues and promote long-term health and stability for patients.

WHY: Caring for patients with substance use disorders in the judicial system and prisons is vital. By addressing addiction in these settings, healthcare providers help break the cycle of crime and addiction, reducing recidivism rates and promoting rehabilitation. Comprehensive care not only improves individual outcomes but also contributes to safer environments for inmates and staff.

Ultimately, addressing substance use disorders within the judicial system and prisons benefits public safety, reduces healthcare costs, and fosters positive societal outcomes.

Main Questions and Objectives.

QUESTION 1: How can we create a non-judgmental and supportive environment for individuals seeking help for substance use disorder?

OBJECTIVE 1: Understand the importance of appropriate language.

QUESTION 2: What personalized approaches can be implemented to address the unique needs and challenges of each patient with substance use disorder?

OBJECTIVE 2: Provide context to understand patient experience for those with substance use disorders.

QUESTION 3: How can healthcare providers effectively communicate empathy and understanding to patients struggling with addiction?

OBJECTIVE 3: Understand the general approach to the treatment of patients with substance use disorders.

QUESTION 4: What resources and support systems can be provided to help patients navigate the journey to recovery?

OBJECTIVE 4: Be able to diagnose different substance use disorders and differentiate between mild, moderate, and severe disorders.

QUESTION 5: How can we ensure continuity of care for patients transitioning between different treatment settings or stages of recovery?

OBJECTIVE 5: Be able to provide safe, compassionate, and adequate care for those with a substance use disorder within a correctional setting.

QUESTION 6: What role do family members and loved ones play in supporting patients with substance use disorder, and how can their involvement be encouraged?

OBJECTIVE 6: Help as many as possible to understand different medications used for opioid use disorder and appropriate use of each one.

Understanding Addition: What is addiction, exactly?

To create a non-judgmental and supportive environment for individuals seeking help for substance use disorder, it helps to understand the biological mechanisms that cause the behavior exhibited by those with substance use disorder.

Understanding Addition: Thoughts vs actions

Summary of Main Points:

Addiction follows a repetitive cycle with three stages: binge/intoxication, withdrawal/negative feelings, and craving/anticipation. These stages worsen over time and involve changes in the brain related to reward, stress, and decision-making.

During binge/intoxication, the brain's basal ganglia drives excessive substance use. Withdrawal/negative feelings activate the extended amygdala, leading to negative emotions and physical symptoms when the substance is stopped.

In craving/anticipation, various brain regions, including the prefrontal cortex, create intense urges and thoughts about using the substance again.

Overall, addiction causes complex changes in the brain, pushing individuals to keep using drugs despite harmful effects.

Addiction involves the brain's response to certain substances, mainly through the release of dopamine, which creates feelings of pleasure or a "high."

This triggers the brain's reward system, driving addictive behavior. Additionally, various neurotransmitters besides dopamine play roles in addiction, affecting motivation, stress, memory, mood, and other functions. During withdrawal, the brain's response to natural rewards decreases, contributing to negative feelings and decreased motivation.

Conditioned reinforcement is a key aspect of addiction:

Certain things or situations can become strongly associated with drug use, even if they weren't connected before. For instance, seeing a specific place or feeling a certain way can trigger strong cravings for drugs.

This association can be so strong that simply passing by a place where drugs were previously bought can spark intense cravings, even after years of abstinence.

Studies with animals demonstrate that over time, the brain learns to expect rewards based on certain signals, like sounds or smells, rather than just reacting to receiving the reward itself. This is similar to how we learn to associate a ringing bell with dinner time.

Individuals with alcohol problems may become fixated on specific types of alcohol or drinking methods because these things trigger increased release of pleasure chemicals in their brains.

Even when someone isn't actively using drugs, these learned associations can still cause cravings, making it extremely challenging to quit.

What exactly is my patient dealing with before they even get to treatment?

Let’s dig a little deeper into the neuroscience of addiction. How does dopamine production impact you every day? And more importantly, what happens to dopamine production in someone with substance abuse disorder?