SUBSTANCE USE DISORDERS (SUDs)
A substance use disorder (SUD) develops when the use of one or more substances leads to significant problems, emotional distress, or failure to meet the responsibilities at home, school, or in the community. It is not unusual that substance use is related to stress, negative peers, or trauma, however a variety of factors contribute to the use of substances. Studies show that almost half of the people diagnosed with a SUD are also diagnosed with a mental health disorder.
Child and Adolescent Behavioral Health utilizes an integrated treatment approach when treating mental and substance use disorders. Integrated treatment is closely related to reduced substance use, fewer arrests, improved mental health and functioning, and an improved quality of life.
Treatment for SUD is determined on the severity of the substance use. Treatment is customized to the needs of the person guided by an individualized treatment plan. Treatment generally is offered in four levels of care: outpatient, intensive outpatient, residential, and imminent danger.
THE FOUR LEVELS OF TREATMENT (C&A does not offer all four services)
Outpatient Services
Outpatient services include individual therapy on a regular basis and may also involve attending a group. Individual therapy is scheduled at the convenience of the individual and fewer than six hours a week. Outpatient services are designed to help the individual make changes in their substance use and/or addictive behavior. Treatment addresses lifestyle, attitudes, and behaviors that may interfere with treatment goals.
Groups provide opportunity to learn information in a school-like setting and encourage interaction with others. Outpatient groups meet weekly and cover topics such as: preparing to change, substance use facts, anger management, self-worth, family and other relationships, or coping skills to name a few. Groups are one hour long and include a workbook that facilitates further thought and action.
Outpatient Services Criteria
- Persons with both mental health and substance use concerns
- Individuals mandated into treatment and not interested in recovery
- Individuals interested in making a change but may not have taken the necessary steps yet
- Persons in need of education about addiction or substance use
- People in recovery who require ongoing monitoring and relapse prevention
Child and Adolescent Behavioral Health provide Outpatient Services.
Intensive Outpatient Programs (IOP)
Intensive outpatient or IOP is considered a Level 2 service according the American Society of Addiction Medicine (ASAM). This level of care often includes the same treatment services as Outpatient in addition to increased clinical contact. IOP generally provide structured programming at a minimum of 6 hours per week. Services typically include group and individual therapy, educational groups, medication management, and family therapy. All treatment is related to a treatment plan with individualized goals. Participants are encouraged to apply newly learned skills to their present day environments.
Level 2 services also include Partial Hospitalization Programs (PHP). PHP is often known as “day treatment” and requires approximately 20 hours of clinical treatment. Child and Adolescent Behavioral Health does not provide PHP for substance use.
Intensive Outpatient Program Criteria
- A diagnosis for substance use and/or other addictive disorder
- The adolescent is not experiencing or at risk of acute withdrawal
- Biomedical conditions are stable or will not interfere with treatment
- At least one of the following occurs:
- Mild risk of dangerous behaviors to self or others
- Recovery efforts are affected by emotional, behavioral, or thinking problems in a negative way
- Mild or moderate difficulty managing daily living or responsibilities at home, school, or work
- The adolescent is likely to become unstable without frequent monitoring and accountability
- The adolescent verbalizes readiness to change but may have unrealistic expectations or does not demonstrate consistent behaviors
- The adolescent has not been successful at a lower level of care or is at risk of relapse
- There is a lack of positive social supports or supportive environment
The length of stay in IOP varies based on the issues being addressed and the adolescents’ response to treatment. Typically IOP services take from 4-8 weeks and then continue at the Outpatient level for as long as needed.
Child and Adolescent Behavioral Health provide IOP collaboratively with CommQuest Services.
Residential Services
Residential treatment occurs in a facility that is staffed 24 hours in order to provide safety and model positive recovery. All services are typically provided within the facility or close by. The length of stay depends on the progress and response of the individual, length of stay is typically longer than IOP services. Treatment involves group, individual, and family therapy, medical monitoring, and education. Residents are encouraged to develop, practice, and demonstrate recovery skills.
Child and Adolescent Behavioral Health does not provide Residential Services.
RESOURCES
WEBSITES
Drug and Alcohol information
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.
National Institute on Drug Abuse (NIDA) is a federal scientific research institute under the National Institutes of Health, U.S. Department of Health and Human Services. NIDA is the largest supporter of the world's research on drug use and addiction.
The Ohio Department of Mental Health and Addiction Services (OMHAS), the consolidation of the Ohio Department of Mental Health (ODMH) and the Ohio Department of Alcohol and Drug Addiction Services (ODADAS) provides information on new and continued initiatives related to prevention, treatment and recovery supports.
Ohio’s official resource for the medical marijuana control program. The Ohio Medical Marijuana Control Program will allow people with certain medical conditions, upon the recommendation of an Ohio-licensed physician certified by the State Medical Board, to purchase and use medical marijuana.
https://medicalmarijuana.ohio.gov/
HB 523 authorizes the use of marijuana for medical purposes. The following link takes you to the decision of the 131 General Assembly and all of the corresponding documents.
https://www.legislature.ohio.gov/legislation/legislation-documents?id=GA131-HB-523
American Society of Addiction Medicine (ASAM) is a professional medical society in the field of addiction medicine dedicated to increasing access and improving the quality of addiction treatment
https://www.asam.org/asam-home-page
A multi-faceted county behavioral health board comprised of expert professionals, dedicated volunteers and concerned community leaders.
Prevention
Governor John R. Kasich and First Lady Karen W. Kasich launched Start Talking! to give parents, guardians, educators and community leaders the tools to start the conversation with Ohio’s youth about the importance of living healthy, drug-free lives.
Just Think Twice is a US Government, Drug Enforcement Administration (DEA) prevention website. The mission of the DEA is to enforce the controlled substance laws in the United States, bring to justice individuals involved in illegal activity, and support reduction programs.
https://www.justthinktwice.gov/
Marijuana
Drug Alert: Marijuana Edibles
https://www.justthinktwice.gov/article/drug-alert-marijuana-edibles
SAMHSA Head Stands Firm on Marijuana's Dangers
https://www.medpagetoday.com/psychiatry/generalpsychiatry/72519
Opiates
ASAM Pocket Guideline
Opioid Addiction Treatment: A Guide for Patients, Families and Friends
The Effects of Opiates on the Body
https://drugabuse.com/featured/the-effects-of-opiates-on-the-body/e Effects of Opiates on the body
SCHOLARLY ARTICLES
Electronic Cigarettes/Vaping
Reasons for Electronic Cigarette Use Among Middle and High School Students – National Youth Tobacco Survey, United States, 2016
Drug Trends
National Adolescent Drug Trends in 2017: Findings Released
Marijuana
Marijuana Buyers in the United States, 2010-2014
The Effect of Medical Marijuana Laws on Adolescent and Adult use of Marijuana, Alcohol, and Other Substances
Adolescent Marijuana Use from 2002-2008: Higher in States with Medical Marijuana Laws, Cause Still Unclear
Medical Marijuana Laws and Adolescent Use of Marijuana and Other Substances: Alcohol, Cigarettes, Prescription Drugs, and other Illicit Drugs
Associations of Personality Traits with Marijuana Use in a Nationally Representative Sample of Adolescents in the United States
“You got to love rosin: Solventless dabs, pure, clean, natural medicine.” Exploring Twitter data on emerging trends in Rosin Tech marijuana concentrates.
Marijuana and self-regulation: Examining likelihood and intensity of use and problems.
Associations between coping and marijuana use in a nationally representative sample of adolescents in the United States
Opiates
Opioid Facts for Teens. Published July 2018 by NIDA
Prescription Opioids and Heroin. Published January, 2018 by NIDA