Drug use and public health

 

As a community based outpatient substance use disorder treatment program, First Step Treatment Center looks at this particular health issue as a public health problem.  In order to address this problem, there are multiple barriers that must be considered.  This blog entry is a brief look at the extent of the problem, and steps that are being taken to address it.

As of 2013, the population of Yamhill County was 100,725.  The use rates for marijuana were 18%, and drugs other than marijuana 10% (within the last 30 days).  The use rates for alcohol “binge drinking” were 26% for adults and 28% for high school 11^th graders.  This data comes from the Yamhill County Public Health Community Assessment, 2013.  http://hhs.co.yamhill.or.us/sites/default/files/fileattachments/yamhill_county_community_health_assessment.pdf

As stated in the article “Illicit drug use by adults is defined as using at least one of the following substances in the past 30 days: Top graph: marijuana or hashish. Bottom graph: cocaine (including “crack”), inhalants, hallucinogens (including PCP and LSD), heroin, or any nonmedical use of analgesics, tranquilizers, stimulants, or sedatives. Illicit drug use has a major impact on individuals, families, and communities. The effects of illicit drug use are cumulative, significantly contributing to costly social, physical, mental, and public health problems. Substance abuse impacts a number of negative health outcomes such as cardiovascular conditions, pregnancy complications, HIV/AIDS, teen pregnancy, sexually transmitted diseases, domestic violence, child abuse, motor vehicle crashes, homicide and suicide (Healthy People 2020).”

While the percentages may seem small, this is survey data dependent upon self reports of use.  Also, keep in mind, reported use in the last 30 days does not necessarily indicate the person has an actual substance use disorder.

What we do know is that within Yamhill County, over the last few years, we have seen a significant growth in opiate abuse that is not just a local, but also a national problem.  Currently, the state of Oregon is taking steps to increase funding to treat this growing problem.  Opiate abuse comes in various forms to include prescription pain medication, and other illegal substances.  This problem continues to increase as reported by multiple agencies including law enforcement, schools, medical, and other service providers.  The problem has reached levels so concerning that we now have law enforcement officers being trained in the use of Naloxone to combat overdoses.

https://www.facebook.com/permalink.php?story_fbid=1652825648332236&id=1552551878359614

One of my consistent messages has always been that the opiate epidemic in part needs to be treated by addressing the abuse of mood altering substances before it reaches the level of opiates.  Not all individuals who use other substances will become an opiate abuser, however, I have rarely met an opiate dependent individual who did not first abuse other substances.

Within Yamhill County, we are fortunate to have a Health and Human Services Department that takes this problem very seriously.  Steps being taken include working with providers to ensure that OHP funding is adequate for those eligible to cover services to treat substance use disorders.  There are still many in the community that are simply not aware that they are eligible for OHP, and that it covers treatment for medical, mental health and substance use disorders.  At First Step, we are fortunate that we take OHP and other forms of private insurance giving us the ability to provide services to a broad range of individuals in the community.  As a community, we must all work together to combat this growing problem that is so detrimental to all of us.

Validation

By Rodney D. Robbins MA CADC III

 

One of the driving factors of addiction, among several, is the need for validation.  Let’s start with the actual definition…

verb (used with object), validated, validating.

1.to make valid; substantiate; confirm:
Time validated our suspicions.

2.to give legal force to; legalize.

3.to give official sanction, confirmation, or approval to, as elected officials, election procedures, documents, etc.:

 Validation brings with it legitimacy.

It is my clinical opinion that the need to feel a sense of “validation” is at least in part at the root of addiction.  We all like to matter.  We ultimately need to have a sense of feeling approval.

There are many sources from which the individual seeks validation.  An often primary source comes from our parents and immediate family.  Finding validation from within the family is healthy, and if this is withheld, the individual can easily be traumatized or go through life feeling as though they are of without value.

The social group is yet another source of validation.  Who we surround ourselves with has a significant impact on how validated we may, or may not feel.  If we are validated for unhealthy behaviors, they are likely to continue.  The reverse is also true.  If we are validated for healthy behaviors, these are likely to continue.

Basically, we all want to matter.. To count for something.  If this need has not been filled, we will seek a remedy to the emptiness that is left behind.  I had a client once tell me “what I was seeking in my addiction, I found in my recovery”.  For the individuals I work with, substance use was a path to temporarily numbing the pain that comes from not feeling like they matter.  Early on, involvement with substances is much more innocent.   However, as the negative consequences of use personally, and around them, began to accumulate, a growing feeling of being worthless continued to grow like a slow cancer.  Subtle at first, but gaining tempo as the use progressed.  Over time, both the use, and the feeling of invalidation led to gradual exclusive contact with only those who also use and feel the same way, thus compounding the process.  This is typically a slow progression, subtle, and often the individual is not completely aware of the deeper processes that are taking place.

Essentially, for those whose use develops into a diagnosable substance use disorder, the deeper need of validation becomes a driving force in their dependence.  A continued pursuit of coping with the pain that comes from these powerful feelings of deeper despair drives this ongoing cycle.  The need to feel valid is strong, and will ultimately be met one way or another.

It is my personal opinion that true validation that satisfies the deepest need comes from a relationship with God.  Along with this spiritual awakening, achieving abstinence and a recovery process free of the abuse of mood altering chemicals will lead to finding the validation that we all truly want.

I am seeing many individuals doing the deeper work of exploring both what it was that damaged their sense of validation, and how to repair it.  You do not have to go through life constantly feeling like you have no value, or do not matter.

Your value before God is a constant, regardless of what you have done.  Substance use will never fill the void that God was meant to fill.