Treatment centers

A dramatically different pattern is found in surveys of drug abuse treatment facilities. Substance abuse treatment centers have reported that more than 20% of patients use benzodiazepines weekly or more frequently, with 30%— 90% of opioid abusers reporting illicit use (Iguchi et al. 1993 Stitzer et al 1981). Methadone clinics reported that high proportions ofurine samples are positive for benzodiazepines (Darke et al. 2003 Dinwiddle et al. 1996 Ross and Darke 2000 Seivewright 2001 Strain et al. 1991 Williams et al. 1996). The reasons for the high rates of benzodiazepine use in opioid addicts include self-medication of insomnia, anxiety, and withdrawal symptoms, as well as attempts to boost the euphoric effects of opioids. 

IA Land application of sludge and solid waste from publicly owned treatment center No permit required if lead level does not exceed 1,000 mg/kg IAC 1986b... 

Congress thus may constitutionally fund sickle-cell anemia treatment centers across the country, even though 97% of persons with the disease are African American (Lee, 2001). Because this is a disease-, not race-, specific... 

Virtual reality may be used in the treatment centers of the future. True or False ... 

Unfortunately, not every treatment center has access to unlimited resources, so some of the previously mentioned positions may be absent from the team, or in some cases a professional may be asked to fulfill more than one role, perhaps a role outside his or her discipline, because no one else is available to handle it. 

Remember, too, that treatment is a business enterprise, and because of this many treatment centers are concerned about the bottom line. Some treatment centers provide high-quality programs, but in other instances the concern about economics overrides concern about client care. This is not a knock on the treatment industry, because the balancing act among economic solvency, profit, and quality of services is true across all other types of health care as well. As a matter of self-protection, try to judge for yourself whether the program you are contemplating has your best interests at heart. 

Third, the center determines during the screening process whether the client is a threat to self or others. Suicidal behavior should be routinely assessed in a screening interview. Some care facilities do not have the resources to treat an actively suicidal client, so if the person expresses suicidal ideations and plans, then a referral may be made elsewhere. The treatment center also wants to protect clients and staff from someone who is extremely aggressive and hostile and may represent a threat to the safety of people in the unit. In some cases, treatment facilities may refer such people elsewhere if the threat cannot be adequately contained within that facility. 

Finally, treatment centers determine whether the client s financial situation will allow him or her to enter into the program offered by the treatment center without hardship. Insurance benefits are checked, after consent has been obtained, in order to determine whether the treatment costs will excessively burden the client. Information about insurance benefits is generally shared with the potential client so that he or she can make an informed decision about whether to engage in therapy, given financial considerations. 

Another way to include collaterals is to offer treatment services to them as well. Many treatment facilities offer such services, which may include family support groups or even individual therapy for family members of clients. Some treatment centers include family therapists specifically for these purposes. Sometimes counselors and therapists will refer family members to outside support groups, which may include Al-Anon or Alateen 12-step programs for family and friends. Family therapy may include assessment, sometimes using similar measures discussed earlier for assessing client needs, in order to more adequately help family members with their needs. In some cases, these assessments may be used to develop a family treatment plan or an individualized treatment plan for a family member. 

Family therapy in treatment centers occurs in a variety of ways. Some centers provide opportunities for weekly individual counseling or therapy for partners, or even couples therapy sessions (see Chapter 5 for more details). Many treatment programs offer group counseling or therapy sessions for family members that are similar to group sessions for clients. Some of the groups are therapeutic... 

As alluded to at the beginning of this section, traditional Minnesota-model treatment merges the disease model with the spiritual model. Since within this model the disease has no known cure, a spiritual solution has taken on importance. Because of this, disease-model counselors refer people to 12-step support groups for continued recovery. Some treatment centers even have spiritual counselors who work with clients on spiritually related goals listed in the treatment plan. This arrangement provides a great service to the many people with drug problems who have spiritual doubts or problems. However, it has been my experience that not everyone who enters treatment feels he or she has a spiritual problem. 

Many treatment centers offer family programs, such as weekly family or couple support groups, that may coincide with the aftercare program that the client attends. In addition, the aftercare counselor may decide that meeting jointly with client and partner can be helpful during aftercare to address relationship... 

Relapse prevention within ethnic-minority communities can look somewhat different than it does in a typical treatment center. Relapse prevention methods with ethnic-minority clients often include involvement in traditional cultural activities as part of the therapy. One important theme may be the restoration of the client into her or his rightful place within the family and the community. Another potentially important cultural issue to address with many ethnic-minority clients will be difficulties overcoming shame. Fligh-risk situations may vary across cultures, and a therapist or counselor should know the community well enough to understand cultural nuances related to risky relapse situations. 

An MCS treatment center that will provide physician referrals in U.S., Canada and other countries. A health educator on staff will answer questions by telephone or via the center s Web site. They have published a book, Less Toxic Alternatives, as a resource guide for all sorts of MCS-aware organizations and products avail-... 

In addition to his research at Edgewood Arsenal, he has broad experience in the area of alcohol and drug abuse and has published numerous scientific articles and book chapters. His teaching activities include many invited lectures, seminars and the direct supervision of medical students. As a clinician he spent 30 years in hospital and office settings, as well as a variety of community clinics and residential treatment centers. Currently he resides and writes at home in Santa Rosa, California. 

It is also important to know about comorbid psychiatric disorders. If these are overlooked, treating the substance use disorder becomes significantly more difficult. Recognizing this, most treatment centers have developed dual diagnosis programs to treat those patients who have another major psychiatric illness in addition to a substance use disorder. It may be virtually impossible to discern at first, but the other psychiatric illnesses might either contribute to or be a result of substance use. The social toll of alcoholism alone can trigger a severe clinical depression. However,... 

The actual level of pressure that can be considered hypertensive is difficult to define it depends on a number of factors, including the patient s age, sex, race, and lifestyle. As a working definition, many cardiovascular treatment centers consider that a diastolic pressure of 90 mm Hg or higher or a systolic pressure of 140 mm Hg or higher represents hypertension. In this chapter, ref-... 

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