Intervene In Drug Addiction

Freddie Lowe

Drug addiction seems inexhaustible, which gives rise to societal debates but continues to be the subject of many reductive representations, even received ideas. The gaze cast on the drug user can be medical, psychological, social, political, legal, or moral…

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it is too rarely transversal. How can professionals confronted with this question find useful benchmarks for their practice? This book aims to provide people working directly or indirectly with drug addicts with validated knowledge.

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It means proven by experience but also with questions likely to enrich their thinking as professionals and citizens alike. Based on facts and scientific data, it offers a historical, sociological, medical, and legislative evolution of considering drug users in France.

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Breaking with the search for explanations and interpretations of drug addiction phenomena, it finally opens up avenues for possible interventions based on human relationships and confrontation with the user, this “Other,” who is ultimately more similar than different.

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Non-Pharmacological Interventions

Non-pharmacological interventions, including physical and psychological strategies to reduce pain, can be used as a first-line measure and adjunct to multi-modality treatment. Non-pharmacological interventions include:

  • Distraction, relaxation, or the use of imagery.
  • Breathing techniques.
  • Music therapy.
  • Spiritual practices.
  • Modify of the environment (such as lowering the light and noise).
  • Change position.
  • Application of cold or heat and transcutaneous electrical neurostimulation .
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Of all these non-pharmacological interventions, only the application of TENS requires a medical prescription. Because effective pain management is a significant medical issue, the Joint Commission requires hospitals to have a system to handle patient pain reports. However, the Joint Commission guidelines do not require a grade 0 pain intensity goal for pain management. Instead, they require a patient-centered approach that considers the risks and benefits of the strategies used to relieve pain and the potential for dependency and abuse.

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Alcohol Consumption

The Joint Commission also supports a multimodal approach that uses pharmacological and non-pharmacological strategies to effectively treat pain. The multimodal approach to treating pain consists of using two or more drugs with different mechanisms of action and non-pharmacological interventions.

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Alcohol Treatment

This patient-centered approach is customized to meet the needs of each patient and often results in lower doses of analgesics and fewer adverse reactions. This study aimed to assess clinical nurses from a tertiary care medical center’s global knowledge, use of non-pharmacological interventions, and the efficacy of pain treatment.

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Methods

This study relied on Watson’s theory of human care for the theoretical framework. Watson’s theory describes a nursing practice with many parts in a relationship between care, holism, and the scientific method. 

It supports the acceptance by nurses of the patient’s assessment of their pain, the importance of comfort in each patient’s life, and a personalized response for each one. This descriptive study used quantitative methods and cross-sectional data collection involving a convenience sample of nurses. Triangulation was used with three different data collection methods to give it more rigor.

Frame And Sample

The setting for this study was a large tertiary care medical center in the US Midwest. Although the center has 31 inpatient nursing units, the study focused on surgical and orthopedic units. These two units were selected based on similarity in size and the pain management needs of the patient population. The participation of the nurses was voluntary, and no name or personal identifying information was recorded.

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Procedure

Freddie Lowe

After institutional review board approval, an online examine was sent to 104 nurses from the two nursing units. Before sending the survey, two educators, four nurses, and the center’s nursing research committee established the content validity of the survey method by reviewing it and reaching a consensus.

The survey method consisted of 15 items. Of these, three demographic items spoke of age, sex, and length of experience as a nurse; two items asked whether the nurse believed she understood nonpharmacologic pain interventions and whether she had used any combination of pharmacologic and nonpharmacologic interventions in her nursing practice, and ten items addressed the use or nonuse of nonpharmacologic interventions.

Data from patient interviews and data review from the Hospital Consumer Healthcare Providers and Systems (HCAHPS ) examine addressed the efficacy of pain management and non-pharmacological interventions and allowed data triangulation. For patient interviews, the principal investigator asked the nurse manager of each unit to recommend patients who were not disoriented but had reported pain.

The principal investigator then went to visit the suggested patients (eight in each unit) and asked them the following questions:

  • Do you feel your nurse(s) have managed your pain well?
  • Have you noticed if techniques other than pharmacological (medications) have been used to support pain treatment?
  • If so, which ones? Hot or cold therapy, music, positioning/repositioning, relaxation and imagery, spiritual practices, superficial massage.
  • Have non-pharmacological interventions helped?
  • During your stay, has more than one nurse offered you any non-pharmacological intervention for pain?
  • Per hospital protocol, HCAHPS surveys emailed to patients after discharge include several items dedicated to patient care and satisfaction. For this study, the HCAHPS analysis was limited to patient responses to one survey item: “During your hospital stay, how often did the hospital staff do everything possible to help you with your pain?”

Discussion And Implications

It was encouraging that all nurses stated that they understood non-pharmacological interventions and reported using pharmacological and non-pharmacological interventions in their nursing practice. However, the limited use of some of the non-pharmacological interventions, such as light massage, relaxation, imagery, and spiritual practices, indicates that more staff training is needed to better encourage the adoption of these strategies. Furthermore, TENS was rarely used as a non-pharmacological intervention. Only seven nurses (10.3%) indicated that they used this intervention. In the center in question, the application of TENS requires a medical prescription. Considering that the systematic review of six studies on TENS showed that it reduces pain

Therefore, education on this strategy and its benefits may prompt nurses to request this intervention when reporting a patient’s pain.

Patient interviews were used, and the principal investigator conducted all interviews. However, he did not review medical records, so it was not clear either the cause or site of the pain or whether the patient’s pain was acute or chronic. In addition, the question to patients about whether their pain has been adequately managed may need to be rephrased more precisely, such as: “Describe how the nurses have tried to relieve your pain.” Based on the response to this open-ended item, the principal investigator could list pharmacological and non-pharmacological interventions and ask which interventions were used.

Although the findings revealed three cases of significance related to the length of nursing experience and specific non-pharmacological interventions, the limitations of this study must be considered. Among these limitations, we find the case of cross-sectional data collection through a convenience sample of nurses in a tertiary care medical center and a relatively small number of patient interviews. Still, the findings provide a foundation for this critical and timely issue and offer further research opportunities. The continued study could shed light on current practice, changing trends in non-pharmacological interventions, and nurses’ age and work experience influence on non-pharmacological interventions.…

Types Of Treatments

Freddie Lowe

There are two types of psychological disorders, both of which are very different:

  • THE PHARMACOLOGICAL TREATMENT
  • THE PSYCHOTHERAPEUTIC TREATMENT _

Pharmacotherapy

The pharmacological treatment uses, as its name indicates, the drugs. It is a symptomatic treatment; that is, it treats the symptoms. For this, he uses medications such as anxiolytics (tranquilizers), antidepressants, and neuroleptics (antipsychotics). among others. These medications alleviate the symptoms as an essential part of emotional disorders. Symptoms are indicators of the existence of a problem.

For example, if a person breaks an arm and it hurts, pain is the symptom that indicates that the arm is broken. The person will take analgesics (pain medications) to alleviate this pain, but his healing will occur if the arm is put back in its place.

Is it wrong for me to take pain medicine? The medicine won’t heal your broken arm; it’ll just remove the pain. The same thing happens when we suffer from a psychological disorder and take medication; it alleviates the symptoms, but we are not cured. In addition, psychological disorders have a psychosocial origin; that is, they depend on the person and their environment.

Imagine that I am suffering from a depressive episode because I am a person who tends to see things in a very negative way (catastrophic thinking), and I have also lost my job. This situation and my way of seeing it produce depressive symptoms in me (sadness, apathy, tiredness, nervousness.). The medication will alleviate those symptoms, but in no way will it change my way of thinking or, of course, give me a job. This is how many people who only treat the symptoms of psychological disorders with medication find that what would first be a few weeks or months of taking medication is years. Every time they try to withdraw it, they logically find themselves very bad.

Medications also have SIDE EFFECTS such as dependence (they are addictive) and tolerance (we need more and more medication to achieve the same effect).

The use of these tranquilizing drugs should not exceed three months, and in many cases, the patient takes them for the rest of his life, and what is worse, the root of his problem is still untreated.

Psychotherapeutic Treatments

Psychotherapeutic treatments approach psychological disorders from a very different perspective than pharmacological treatments.

They start from the premise that psychological disorders are not diseases like diabetes or the flu but are disorders that, in addition to affecting physiology (bodily symptoms), also affect the way people think, their behavior, and their environment. Social and family. For this reason, its treatment must encompass all these areas and not only the symptomatological aspect of pharmacological treatments.

All these aspects are those that are behind the symptoms and those that the psychotherapeutic treatment addresses individually with the affected person.

Cognitive behavioral therapy is the most effectual and modern form of psychotherapy for psychological disorders. Based mainly on the distorted or dysfunctional interpretations that appear in psychological disorders and directly influence the individual’s behavior and emotions, it is the most studied and effective method of psychotherapeutic treatment.

Are Psychological Treatments Effective?

The effectiveness of drugs and psychological treatments. Psychological difficulties are a more common health problem than is generally believed.

The UN estimates that 1 in 4 people will experience a mental wellness problem in their lifetime. In addition, the economic and health crises in recent decades have considerably increased accumulated stress, increasing the risk of mental health damage.…

What Treatments Do Mental Health Professionals Offer Us?

Freddie Lowe

From psychiatry and psychology, two main types of treatments are provided for improving mental health: treatments with psychoactive drugs and treatments with psychological therapies.

In response to mental health problems, many people turn to drug intervention. The 2017 ENSE National Health Survey observed that 1 in 10 people take some tranquilizer/anxiolytic and 1 in 20 antidepressants. These treatments offer practical solutions in many cases that help reduce the problems associated with many problems. For example, they favor more balanced mental states, facilitate sleep conciliation, reduce activation levels, etc.

In addition to psychoactive drugs, mental health professionals can provide us access to psychological treatments, but what do they add concerning psychoactive drugs?

The Advantages Of Drugs And Psychological Treatments

  1. They Are Effective

When we think about psychological therapy, one of the questions that may come to mind is whether it is beneficial and whether or not it will help us solve our problems. In this regard, scientific evidence indicates that psychological treatments are effective.

Psychotherapy is a practical support to reduce chronic problems such as depression, anxiety, substance use, or bipolar disorder. Psychological and pharmacological treatment offer similar effectiveness in reducing discomfort related to many problems, such as depression or bipolar disorder. However, in specific problems, such as in many cases of anxiety, the effectiveness of psychological treatments is even higher than pharmacological treatments.

  1. They Reduce The Probability Of Relapses

Psychological treatment offers a higher success rate than pharmacological treatment in relapse prevention. This means that a person who has overcome a mental problem with psychological treatment is less likely to re-experience previous difficulties than someone who has overcome it with psychotropic drugs.

  1. They Have A Long-Term Effect

The successes we achieve with psychotherapy are maintained over time. While the effect of the drugs is as long as we continue the treatment, the effect of psychotherapy extends beyond the end of the sessions. With psychological treatments, people learn new ways of behaving that help us manage our lives more adaptively and are useful after therapy in new situations.

  1. They Do Not Generate Addiction

One of the advantages of psychological therapy is that it does not generate addiction problems. On the contrary, some psychoactive drugs, such as anxiolytics and hypnotics, generate significant levels of dependency, making many people need them to face their day-to-day. Faced with this situation, psychological treatments do not generate these addiction problems but rather make us more autonomous by providing us with skills that make us more independent.

  1. They Have No Side Effects

Psychological treatments have less impact on the organism than psychoactive drugs. While medications can cause adverse effects, one of the advantages of psychotherapy is intervention without harmful side effects for the body.

  1. They Can Be Combined With Psychotropic Drugs

Psychological interventions can be combined with psychotropic drugs. For some people, this combination of psychological and pharmacological treatment is the most effective treatment.

In the case of treatment for schizophrenia, the combination of psychotropic drugs with psychological therapy reduces hospitalization periods, psychotic episodes, the amount of medication, etc.

In mood problems, antidepressants facilitate our brain’s ability to change, adapt, and learn new things. Combining this with psychotherapy would make it easier for this fertile ground to bear fruit by providing direction and driving change.…

The Disadvantages Of Psychological Treatments

Freddie Lowe

They Have A High Cost

The reality of the health system shows few mental health professionals in the population. This is an even bigger problem in public health, where mental health care is saturated. For this reason, many people resort to private health services, a cost that not everyone can bear.

They Require Effort

Psychological therapy involves changing the behaviors that we have learned, which is not easy. Proposing to carry out psychological therapy means facing the way of responding to situations that are easier for us, our habits, unpleasant emotions, etc. Those people who decide to change their behavior have to invest effort.

Then…. Psychopharmaceuticals Or Psychotherapy?

The choice of treatment in psychotropic drugs, psychotherapy treatment, or a combination of both depends on the problem being addressed.

In general, international associations such as The American Psychological Association (APA), or The National Institute for Health and Clinical Excellence (NICE) propose psychotherapy as the primarily recommended treatment for problems such as depression disorders, anxiety, or post-traumatic stress. Likewise, psychotherapy is recommended as a priority treatment for minors or people with previous illnesses due to its lower impact on physical health.

Although, there are cases in which medication with psychotropic drugs is considered a fundamental axis, and the combination with psychotherapy is the best treatment. Examples of these cases are treatments for schizophrenia, bipolar disorder, or severe depression. In these cases, psychotropic drugs provide stabilization and improvement of the mental state, and psychotherapy facilitates recovery, better adherence to treatment, shorter treatment times, fewer relapses, etc.

In summary, both pharmacological and psychological therapy can be effective, and, for some people and cases, combining both treatments increases the therapeutic success of either one in isolation.

To know the best treatment in each case, it is essential to have an individual evaluation and advice from a professional psychologist because the choice of treatment will depend on each person’s specific circumstances.

Evaluation Of An Educational Family Intervention Program

An educational intervention strategy is presented in extended families belonging to the care area of ​​the “Mario Escalona Reguera” Polyclinic of the Alamar District, Habana del Este municipality, in Havana City, applied to a group made up of representatives of each of the families that had previously been identified and selected from the family files of the offices of a Basic Working Group of said health institution. The natural and felt learning needs that the participants had about family functioning were identified, with which the design of an Intervention Program adjusted to said needs was achieved, which was developed by sessions based on the participatory communication method. The group in which progress was evaluated, effectiveness, and impact. A reduction in the learning needs of family functioning.

The life cycle was achieved, which translates into the incorporation of the knowledge obtained in the work sessions on the dynamics of the families involved, better preparation of the families, as well as a favorable modification of their diagnoses of family functionality determined by the Family Functioning Perception Test (FF-SIL). The program’s progress was classified as positive and exciting, according to the PNI technique (positive, negative, and interesting), and its participants always maintained a high emotional state and a willingness to participate. It was effective, as demonstrated by comparing the results of applying the instrument and the technique selected for this purpose. Its impact was also positive among the participants and family members, who expressed their expectations of improving their lives as a family group.

Educational family intervention 16It refers to the process that allows the family to receive information, produce knowledge on specific health issues and promote reflection. It intends to stimulate the adoption of healthy lifestyles and functional relationship patterns and adapt to changes, including health-disease changes. This type of intervention can be carried out in different community spaces. Cuba has a social infrastructure that allows this area to be used to work preventively in the family. Each community has health institutions (polyclinic, Family Doctor), which make available to the psychologist a dispensary population and other institutions that handle social problems.

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