what happens if a prominent politician is found to have sold drugs in college

Lisa is a 19-yr-erstwhile White college student living in San Diego, CA, who was sent to handling by her parents later failing her college classes and being placed on bookish probation. While abode on break earlier that yr, her parents found pills in her room but allow her return to school afterwards she promised to terminate using. The bookish probation is only part of the reason her parents sent her to treatment. They were also concerned nearly her contempo weight loss, equally her older sister had previously struggled with bulimia.

Lisa began using marijuana at age fifteen with a cousin. In her first twelvemonth of high school, she had difficulty plumbing fixtures in. However, the next year, she became friendly with an electronic dance music clique that helped her ascertain an identity for herself and introduced her to ecstasy (three,4-methylenedioxymethamphetamine, or MDMA), methamphetamine, and various hallucinogens, along with new ideas about politics, music, and art. She has since plant similar friends at college and keeps in touch with several members of her high school clique.

In treatment, Lisa tells her counselor that she has long felt neglected by her parents, who are too interested in material things. She sees her drug use and that of her friends as a rebellion against the materialistic attitudes of their parents. She also dismisses her family's cultural heritage, insisting that her parents merely identify as Americans even though they are first-generation Americans with European backgrounds. She talks at length about ways to larn and fix relatively unknown hallucinogens, the best music to mind to while using, and how to evaluate the quality of marijuana.

Lisa says that she doesn't believe she has a problem. She thinks that her failing grades reflect her lack of involvement in higher, which she says she is attention simply considering people expect information technology of her. When asked what she would rather be doing, she says she does not take any clearly defined goals and just wants to do "something with art or music." Lisa points out that, different virtually of her classmates, she doesn't drink and has stopped doing addictive drugs similar ecstasy and methamphetamine, which were responsible for her weight loss. She is convinced that she can go along to smoke pot and Salvia divinorum, which she notes "isn't fifty-fifty illegal," and have other botanical hallucinogens. She is adamant about keeping her friends, who she says have been supportive of her and are not materialistic "sellouts" like her parents.

This Treatment Comeback Protocol (TIP) emphasizes the concept that many subcultures exist within and across diverse ethnic and racial populations and cultures. Drug cultures are a formidable example—these are cultures that can influence the presentation of mental, substance apply, and co-occurring disorders besides as prevention and treatment strategies and outcomes.

Her advisor places a priority on connecting Lisa with other people her age who are in recovery. She asks a client who graduated from the program and is only a year older than Lisa to accompany her to Narcotics Bearding (NA) meetings attended mostly by younger people in recovery. The counselor too encourages Lisa'due south friendships with other young people in the program. When Lisa complains about her parents' materialism and the materialism of mainstream culture, her counselor brings upwards the spiritual elements of mutual-help recovery groups and how they provide an alternative model for interacting with others. The advisor begins to help Lisa explore how her drug utilise may be an attempt to fill her unmet emotional and social needs and may hinder the development of her own interests, identity, and goals.

Multidimensional Model for Developing Cultural Competence: Drug Cultures

Treatment providers should consider how cultural aspects of substance use reinforce substance apply, substance use disorders, and relapses. Factors to note include clients' possible self-medication of psychological distress or mental disorders. Beyond specific biopsychosocial issues that contribute to the run a risk of substance-related disorders and the initiation and progression of use, counselors and treatment organizations must continually acquire knowledge about the ever-changing, diverse drug cultures in which customer populations may participate and which reinforce the employ of drugs and alcohol. Moreover, behavioral health service providers and programme administrators demand to translate this knowledge into clinical and authoritative practices that accost and counter the influence of these cultures within the treatment environs (e.g., past instituting policies that ban styles of dress that point amalgamation with a item drug culture).

Adopting Sue's multidimensional model (2001) for developing cultural competence, this chapter identifies drug cultures as a domain that requires proficiency in clinical skills, programmatic evolution, and administrative practices. It explores the concept of drug cultures, the relationship between drug cultures and mainstream culture, the values and rituals of drug cultures, and how and why people value their participation in drug cultures. This chapter describes how counselors can decide a client'south level of interest in a drug culture, how they can help clients identify and develop alternatives to the drug cultures in which they participate, and the importance of assisting clients in developing a culture of recovery.

What Are Drug Cultures?

Up to this indicate, this TIP has focused on cultures based on ethnicity, race, language, and national origin. The TIP looks primarily at those cultural groups considering they are the major cultural forces that shape an individual's life and worldview. Withal, there are other types of cultural groups (sometimes referred to every bit subcultures) that are also organized around shared values, beliefs, customs, and traditions; these cultural groups can have, as their core organizing theme, such factors as sexuality, musical styles, political ideologies, and and so on. For well-nigh clients in treatment for substance use disorders (including those who take a co-occurring mental disorder), the drug subculture volition likely take affected their substance utilise and can bear upon their recovery; that is the primary rationale for the development of this unique chapter. Enquiry literature in this topic area is considerably limited.

Some people question whether a given drug civilization is in fact a subculture, only many seem to accept all the elements ascribed to a culture (come across Chapter i). A drug civilisation has its own history (pertaining to drug use) that is usually orally transmitted. It has sure shared values, beliefs, customs, and traditions, and information technology has its own rituals and behaviors that evolve over fourth dimension. Members of a drug culture often share similar ways of dressing, socialization patterns, language, and way of advice. Some fifty-fifty develop a social hierarchy that gives different status to different members of the culture based on their roles within that culture (Jenkot 2008). As with other cultures, drug cultures are localized to some extent. For example, people who utilise methamphetamines in Hawaii and Missouri could share certain attitudes, but they volition likewise showroom regional differences. The text boxes in this chapter offer examples of the distinct values, languages, rituals, and types of artistic expression associated with particular drug cultures.

Many subcultures exist outside mainstream club and thus are prone to fragmentation. A single subculture tin split up into iii or 4 related subcultures over time. This is peculiarly true of drug cultures, in which people utilise different substances, are from different locales, or have dissimilar socioeconomic statuses; they may also take very different cultural attitudes related to the utilise of substances. Bourgois and Schonberg (2007) described how ethnic and racial differences tin bear on the drug cultures of users of the same drugs to the point that even such things as injection practices can differ between Black and White heroin users in the aforementioned city. Exhibit vi-1 lists of some of the ways in which drug cultures tin can differ from 1 another.

Differences in the physiological and psychological effects of drugs account for some differences among drug cultures. For example, the drug culture of people who use heroin is typically less frenetic than the drug culture involving methamphetamine utilise. Still, other differences seem to be more clearly related to the historical evolution of the civilisation itself or to the furnishings of larger social forces. Cultural and socioeconomic components contributed to the rise in methamphetamine apply amongst gay men on the West Declension (Reback 1997) and among Whites of lower socioeconomic status in rural Missouri (Topolski and Anderson-Harper 2004). However, in these two cases, the details of those alter factors are quite different. In Missouri, the low cost and piece of cake production of the drug influenced development of a methamphetamine drug civilization. Missouri leads the nation in the number of methamphetamine labs seized by constabulary; a unduly large number of seizures occur in rural areas (Carbone-Lopez et al. 2012; Topolski and Anderson-Harper 2004). The popularity of the drug among Whites could be linked to the historical development of the methamphetamine merchandise by White motorcycle gangs (Morgan and Brook 1997). On the other hand, most gay men who use the drug study having first used it at parties with the expectation of involvement in sexual activity (Hunt et al. 2006). In studies of gay men who used methamphetamine, the main reason for employ was to enhance sexual experience (Halkitis et al. 2005; Kurtz 2005; Reback 1997). Morgan and Beck (1997) establish that increased sexual activity was ane reason why sure women and heterosexual men used methamphetamine, only it was non equally important a reason every bit information technology was for gay men.

How To Identify and Hash out Key Characteristics of a Drug Civilisation

Counselors and clinical supervisors must acquire knowledge about drug cultures represented within the client population. Drug cultures tin can alter chop-chop and vary across racial and ethnic groups, geographic areas, socioeconomic levels, and generations, and then staying informed is challenging. Besides needing an understanding of current drug cultures (to assist prevent infiltration of related behaviors and attitudes within the treatment environment), counselors also demand to assist clients empathize how such cultures support apply and pose dynamic relapse risks.

Counselors tin can utilize this exercise to begin to educate clients near the influence of drug cultures and help them identify the specific behaviors, values, and attitudes that found their feel of using alcohol and drugs. It can exist a helpful tool in improving clients' understanding of the reinforcing aspects of booze and drug use beyond physiological effects. In addition, this exercise can be used as a training tool in clinical supervision to aid counselors understand the influence and potential reinforcing qualities of a drug culture amidst clients and within the treatment milieu.

Materials needed: Diagram handout and pencils.

Instructions:

• Determine whether this exercise is more appropriate every bit an individual or group practise. Assess the newness and variability of recovery within the group constellation. If several group members support recovery-related behavior, conducting this exercise may be a beneficial educational tool and means of intervention with clients who go on to place mainly with their drug culture. Conversely, if most grouping members are new or accept had difficulty accepting treatment or treatment guidelines, this exercise may exist more aptly used as an individual tool.

• Attention: In group settings, strict parameters need to be established at the beginning of the session to ensure that the give-and-take remains centered on attitudes, values, and behaviors surrounding drug and alcohol utilise—not on specific techniques or procedures for using drugs or rituals surrounding intake or injection.

• Starting time the discussion by beginning presenting the idea that drug cultures exist—describing the primary elements that constitute culture (refer to Chapter 1 or the categories identified in the "Drug Civilization" diagram below). Next, provide examples of how drug culture can support connected apply and relapse. Keep in mind that non all clients are engaged in a drug culture.

• Following the general introduction, review each block in the diagram and enquire clients to provide examples related to their ain utilize and involvement with drugs and alcohol. After discussing their examples, inquire them to identify the near significant behaviors, attitudes, and values that reinforce their employ (e.g., a feeling of credence or camaraderie).

• Counselors tin redirect this full general word to related topics—for example, by identifying behaviors, values, and attitudes likely to support recovery or by shifting from give-and-take to role-plays that will help clients address relapse risks associated with their drug culture and exercise coping skills (east.g., assertiveness or refusal skills to counter the influence of others once they are discharged from the plan or to accost situations that arise during the course of treatment).

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Drug Culture
Establishing Trust and Credibility How practise you go well-nigh establishing credibility?	Socialization How were y'all introduced to the civilization?	Values What values are upheld or devalued in the grouping?
Status In what ways tin can yous obtain status or be seen equally a success?	Rules Are there spoken and unspoken rules or norms?	Gender Roles and Relationships What gender expectations exist surrounding drug use?
Concepts of Sanction, Penalisation, and Conflict Mediation How does the grouping bargain with in-grouping conflicts?	Symbols and Images Are there symbols that represent a particular association with a group or substance?	Dress Are in that location specific means to dress that show allegiance to a specific substance or group?
View of By, Nowadays, and Futurity Are there specific beliefs about the past, present, and/or hereafter?	Linguistic communication & Communication Are there special verbal or nonverbal ways to communicate about substance-related activities?	Attitudes What are common attitudes toward others (nonusers, police, etc.)?

This chapter aims to explain that people who use drugs participate in a drug civilisation, and further, that they value this participation. However, not all people who abuse substances are office of a drug culture. White (1996) draws attention to a set of individuals whom he calls "acultural addicts." These people initiate and sustain their substance utilise in relative isolation from other people who use drugs. Examples of acultural addicts include the medical professional person who does not accept to use illegal drug networks to abuse prescription medication, or the older, eye-course individual who "pill shops" from multiple doctors and procures drugs for misuse from pharmacies. Although drug cultures typically play a greater role in the lives of people who use illicit drugs, people who use legal substances—such as booze—are also likely to participate in such a culture (Gordon et al. 2012). Drinking cultures tin can develop among heavy drinkers at a bar or a college fraternity or sorority house that works to encourage new people to utilise, supports high levels of continued or binge apply, reinforces denial, and develops rituals and customary behaviors surrounding drinking. In this chapter, drug culture refers to cultures that evolve from drug and alcohol use.

The Relationship Betwixt Drug Cultures and Mainstream Culture

To some extent, subcultures define themselves in opposition to the mainstream culture. Subcultures may refuse some, if not all, of the values and beliefs of the mainstream culture in favor of their own, and they will ofttimes adapt some elements of that culture in ways quite different from those originally intended (Hebdige 1991; Issitt 2009; Exhibit half-dozen-two). Individuals ofttimes identify with subcultures—such every bit drug cultures—because they feel excluded from or unable to participate in mainstream society. The subculture provides an culling source of social support and cultural activities, but those activities tin run counter to the best interests of the individual. Many subcultures are neither harmful nor antisocial, but their focus is on the substance(southward) of abuse, non on the people who participate in the civilisation or their well-existence.

Mainstream civilization in the U.s.a. has historically frowned on most substance apply and certainly substance corruption (Corrigan et al. 2009; White 1979, 1998). This can extend to legal substances such every bit alcohol or tobacco (including, in recent years, the increased prohibition against cigarette smoking in public spaces and its growing social unacceptability in individual spaces). As a result, mainstream civilisation does non—for the most part—accept an accepted role for well-nigh types of substance use, different many older cultures, which may accept use, for example, every bit part of specific religious rituals. Thus, people who experiment with drugs in the United States usually exercise so in highly marginalized social settings, which can contribute to the development of substance use disorders (Wilcox 1998). Individuals who are curious about substance employ, particularly young people, are therefore more likely to become involved in a drug culture that encourages excessive employ and experimentation with other, often stronger, substances (for a review of intervention strategies to reduce discrimination related to substance apply disorders, run across Livingston et al. 2012).

When people who abuse substances are marginalized, they tend not to seek access to mainstream institutions that typically provide sociocultural back up (Myers et al. 2009). This can consequence in fifty-fifty stronger bonding with the drug culture. A marginalized person's beliefs is seen as abnormal even if he or she attempts to deed differently, thus further reducing the chances of whatever try to change behavior (Cohen 1992). The drug civilisation enables its members to view substance use disorders every bit normal or fifty-fifty as status symbols. The disorder becomes a source of pride, and people may gloat their drug-related identity with other members of the culture (Pearson and Bourgois 1995; White 1996). Social stigma besides aids in the formation of oppositional values and behavior that tin promote unity amongst members of the drug culture (Exhibit 6-iii).

When people with substance use disorders experience discrimination, they are likely to filibuster entering handling and tin have less positive handling outcomes (Fortney et al. 2004; Link et al. 1997; Semple et al. 2005). Discrimination tin besides increase denial and pace upward the individual's attempts to hide substance apply (Mateu-Gelabert et al. 2005). The immorality that mainstream society attaches to substance use and abuse can unintentionally serve to strengthen individuals' ties with the drug civilisation and decrease the likelihood that they will seek handling.

The human relationship betwixt the drug and mainstream cultures is not unidirectional. Since the beginning of a definable drug civilization, that culture has had an effect on mainstream cultural institutions, particularly through music (Exhibit 6-4), art, and literature. These connections tin add significantly to the attraction a drug civilization holds for some individuals (especially the young and those who pride themselves on being nonconformists) and create a greater gamble for substance use escalating to abuse and relapse.

Understanding Why People Are Attracted to Drug Cultures

To understand what an private gains from participating in a drug culture, information technology is important first to examine some of the factors involved in substance use and the development of substance use disorders. Despite having differing theories about the root causes of substance employ disorders, most researchers would agree that substance abuse is, to some extent, a learned behavior. Start with Becker's (1953) seminal work, inquiry has shown that many commonly abused substances are not automatically experienced as pleasurable by people who utilise them for the beginning time (Fekjaer 1994). For instance, many people notice the taste of alcoholic beverages bellicose during their first experience with them, and they only learn to experience these effects equally pleasurable over time. Expectations can besides be of import among people who use drugs; those who have greater expectancies of pleasure typically accept a more intense and pleasurable feel. These expectancies may play a part in the development of substance use disorders (Fekjaer 1994; Leventhal and Schmitz 2006).

Additionally, drug-seeking and other behaviors associated with substance use have a reinforcing effect across that of the bodily drugs. Activities such as rituals of use (Showroom 6-5), which brand upwards part of the drug civilization, provide a focus for those who apply drugs when the drugs themselves are unavailable and help them shift attention abroad from problems they might otherwise demand to face (Lende 2005).

Drug cultures serve as an initiating force also equally a sustaining force for substance use and abuse (White 1996). Every bit an initiating strength, the culture provides a fashion for people new to drug use to learn what to expect and how to appreciate the experience of getting high. As White (1996) notes, the drug culture teaches the new user "how to recognize and savor drug effects" (p. 46). At that place are also practical matters involved in using substances (east.1000., how much to take, how to ingest the substance for strongest issue) that people new to drug utilize may not know when they first brainstorm to experiment with drugs. The skills needed to apply some drugs can be quite complicated, equally shown in Exhibit six-6.

Exhibit 6-half dozen

Questions Regarding Knowledge and Skill Demands of Heroin Apply.

The drug civilization has an appeal all its ain that promotes initiation into drug use. Stephens (1991) uses examples from a number of ethnographic studies to show how people can be as taken past the excitement of the drug culture as they are by the drug itself. Media portrayals, forth with vocalizer or music grouping autobiographies, that glamorize the drug lifestyle may increase its lure (Manning 2007; Oksanen 2012). In ownership (and perhaps selling) drugs, individuals can find excitement that is missing in their lives. They tin can likewise notice a sense of purpose they otherwise lack in the daily need to seek out and acquire drugs. In successfully navigating the difficulties of living as a person who uses drugs, they can gain blessing from peers who apply drugs and a feeling that they are successful at something.

In some communities, participation in the drug trade—an aspect of a drug culture—is simply 1 of the few economic opportunities available and is a means of gaining the admiration and respect of peers (Bourgois 2003; Simon and Burns 1997). Nonetheless, drug dealing as a source of status is non limited to economically deprived communities. In studying drug dealing among relatively affluent college students at a individual college, Mohamed and Fritsvold (2006) constitute that the near important motives for dealing were ego gratification, status, and the desire to presume an outlaw image.

Marginalized adolescents and immature adults find drug cultures specially appealing. Many individual, family unit, and social risk factors associated with boyish substance abuse are likewise adventure factors for youth interest with a drug culture. Individual factors—such as feelings of alienation from order and a potent rejection of authority—can cause youth to look outside the traditional cultural institutions available to them (family, church, school, etc.) and instead seek acceptance in a subculture, such as a drug culture (Hebdige 1991; Moshier et al. 2012). Individual traits like sensation-seeking and poor impulse control, which tin can interfere with functioning in mainstream guild, are often tolerated or tin can be freely expressed in a drug civilization. Family involvement with drugs is a significant gamble factor due to boosted exposure to the drug lifestyle, as well equally early on learning of the values and behaviors (due east.g., lying to cover for parents' illicit activities) associated with information technology (Haight et al. 2005). Social hazard factors (e.g., rejection by peers, poverty, failure in school) tin also increase young people's breach from traditional cultural institutions. The demand for social acceptance is a major reason many young people begin to use drugs, as social acceptance can be plant with less effort within the drug culture.

In addition to helping initiate drug utilize, drug cultures serve every bit sustaining forces. They support continued utilise and reinforce deprival that a problem with alcohol or drugs exists. The importance of the drug culture to the person using drugs oftentimes increases with time as the person's association with it deepens (Moshier et al. 2012). White (1996) notes that as a person progresses from experimentation to abuse and/or dependence, he or she develops a more intense need to "seek for supports to sustain the drug human relationship" (p. ix). In addition to gaining social sanction for their substance use, participants in the drug civilization learn many skills that can assistance them avoid the pitfalls of the substance-abusing lifestyle and thus continue their use. They learn how to avoid arrest, how to get money to support their habit, and how to find a new supplier when necessary.

The more an individual'southward needs are met within a drug culture, the harder information technology will exist to get out that civilisation behind. White (1996) gives an instance of a person who was initially attracted in youth to a drug civilisation because of a desire for social acceptance and and then grew upwards within that culture. Through involvement in the drug civilization, he was able to proceeds a measure out of self-esteem, change his family unit dynamic, explore his sexuality, develop lasting friendships, and find a career path (admitting a criminal i). For this individual, who had then much of his life invested in the drug civilization, it was as hard to conceive of leaving that culture equally it was to conceive of stopping his substance use.

Online Drug Cultures

One major change that has occurred in drug cultures in recent years is the development of Net communities organized effectually drug utilise (Gatson 2007a; Murguia et al. 2007) and drug use facilitation, including information on use, product, and sales (Bowker 2011; U.S. Section of Justice 2002). Such communities develop around Spider web sites or word boards where individuals can describe their drug-related experiences, find information on acquiring and using drugs, and discuss related issues ranging from musical interests to legal problems. Many of the Spider web sites where these online communities develop are originally created to lessen the negative consequences of substance apply by informing people about diverse related legal and medical issues (Gatson 2007b; Murguia et al. 2007). As in other drug cultures, users of these Web sites and discussion boards develop their own language and values relating to drug use. Club drugs and hallucinogenics are the near often-discussed types of drugs, merely online communities involve the word of all types of licit and illicit substances, including stimulants and opioids (Gatson 2007a; Murguia et al. 2007; Tackett-Gibson 2007).

How To Pb an Exercise Examining Benefits, Losses, and the Time to come

Counselors and clinical supervisors can help clients identify reinforcing aspects (also physiological effects) of their drug and alcohol utilise and the losses associated with use, including unmet goals and dreams. The physiological, social, and emotional gains and losses that have transpired during their use (whether or non they acquaintance these losses with their use) tin can serve as risks for relapse. This practice works well as an interactive psychoeducational lecture for clients, as a training tool for counselors, and as a group counseling do. It can as well be adjusted for individual sessions.

Materials needed: Group room with sufficient space to movement effectually.

Instructions:

• Select an amenable customer aware of the losses and consequences associated with his/her employ. After in the exercise, select other clients to give other group members a more than direct feel.

• Dissever the group in two. For large groups, select only 6 to 8 people for each side. Have each subgroup stand on opposite sides of the room facing each other. One group will represent the benefits of use; the other, losses associated with use (encounter diagram for room set-upwardly).

• Rather than using the customer's personal benefits and losses (at to the lowest degree initially), ask group members to brainstorm about their experiences that represent each side. Begin with the side of the room that represents "benefits of use" and inquire anybody in the room to proper name some benefits. Then, assign a specific benefit to each person in the "benefits of use" group and create a i-line message for each (a first-person statement describing the benefit), asking the representative client to remember the line. For example, if the group named a benefit of use as firsthand credence from others who use, assign this do good to 1 person and create a message to capture information technology: "I make you feel like you belong," or "We are family now." Continue brainstorming until you have assigned six or more benefits.

• Next, get to the opposite group that represents the losses associated with utilise and begin to solicit losses from everyone in the room. Assign a loss to each person in the "loss" group, create a one-line message that coincides with each loss, and then inquire an individual to remember each loss message (east.g., "I am the loss of your children," "I am the loss of your cocky-respect," "I am the loss of your health"). In add-on, ask the group to name futurity goals and plans that were curtailed because of use. Assign these losses as well, following the same format (east.g., "I am the loss of a college degree," "I am the loss of intimate relationships," "I am the loss of belief in the future"). Notation: If you run out of people, you lot tin can assign two roles to one person.

• At this point, the exercise can already be a powerful experience for many clients. Now, have the person who was originally selected equally the client stand facing the "benefits of use" group. Take the client process what it is like to see the benefits of utilise. Y'all can also have each person in the "benefits of use" group state his or her one-line message to help facilitate this process. Stand up with the client as he or she moves to the "loss" group. Again, accept the client stand up and face this grouping while asking him or her what it is like to meet the losses, including the losses related to goals and the hereafter. Note: Information technology is not of import equally an exercise to have benefits or losses specific only to this customer. Information technology is far ameliorate to gain a sample from the unabridged group so that everyone is involved and to maximize the exercise's effectiveness as a psychoeducational tool.

• After the customer has stood in forepart of both groups, ask him or her to move back and along between each group several times to run into what emotional changes occur in experiencing each group. It is of import to procedure this experience as a group. You can invite other members to switch out of their roles and stand in every bit clients to experience this exercise more straight. Clients are likely to meet how seductive the "benefits of use" group tin exist and how this attraction tin can lead back to relapse. This exercise may besides assist clients connect with the losses associated with their use. At times, clients may gain awareness that the very losses associated with their apply tin can also serve as a trigger for use every bit a ways of cocky-medicating feelings.

• Allot sufficient time for this psychoeducational lecture—not only to demonstrate the benefits and losses associated with employ, but as well to enable the group to procedure their thoughts and feelings.

Murguia et al. (2007) reported on a survey of developed (ages 18 and older) participants in i online community. The cocky-selected survey sample included i,038 respondents, 80 percent of whom were from the United states of america. Respondents were likely to exist young (ninety percent were under 30), male (76 pct), White (92 percent), relatively flush (58 percent had household incomes of $45,000 or more), employed (41 percent were employed total time; another 28 percent, part fourth dimension), and/or in school (57 percentage were attending school full or part time). According to the 2011 National Survey on Drug Use and Health, approximately 0.3 percent of individuals 12 years of historic period or older buy prescription drugs through the Cyberspace (SAMHSA, 2012b).

The Function of Drug Cultures in Substance Abuse Handling

Most people seek some kind of social affiliation; information technology is ane aspect of life that gives meaning to day-to-day being. Behavioral wellness service providers can improve empathize and help their clients if they take an understanding of the culture(s) with which they identify. This understanding can exist even more important when addressing the role of drug culture in a client'south life considering, of all cultural affiliations, it is likely to be the i about intimately connected with his or her substance corruption. The drug culture is likely to have had a considerable influence on the client'south behaviors related to substance use.

Drug Cultures in Assessment and Engagement

The kickoff stride in understanding the role a drug culture plays in a client's life is to assess which drug culture(s) the customer has been involved with and his or her level of involvement. There are no textbooks that can inform providers about the drug cultures in their areas, but counselors probably know quite a bit most them already, as they learn much most drug cultures through talking with their clients. Counselors who are themselves in recovery may be familiar with some clients' substance-using lifestyles and social environments or will have insight into how to explore the issue with clients. They tin can too brainwash their colleagues.

Providers who accept never personally abused substances tin can learn from recovered counselors as well as from their clients. All the same, asking a client point-blank about his or her involvement in a drug culture is likely to be answered with a blank stare. Instead, talking to clients about their relationships, daily activities and habits relating to substance employ, values, and views of other people and the earth tin allow providers to develop a good sense of the meanings drug cultures hold for clients.

To engage a client in handling, understanding his or her human relationship with a drug civilisation may be as of import as understanding elements of that customer's racial or indigenous identity. Clients are unlikely to cocky-identify as members of the drug culture in the aforementioned mode that they would identify as an African American or Asian American, for example, but they can notwithstanding be offended or distrustful if they recall the provider or program does non empathize how their lifestyle relates to their substance use. Affiliation with a drug culture is a source of client identity; the client's place in the drug civilization can be important to his or her self-esteem.

Subsequently the assessment and date stage, the provider'southward attitude toward the customer's participation in a drug civilisation will exist significantly different from his or her mental attitude toward the client's other cultural affiliations. Equally near providers already know (fifty-fifty if they do not employ the term drug culture), if a customer continues to exist closely affiliated with the drug-using life, then he or she is more probable to relapse. The people, places, things, thoughts, and attitudes related to drug and/or alcohol utilise human activity as triggers to resume utilise of substances. Behavioral health service providers demand to help their clients weaken and eventually eliminate their connections to the drug culture. White (1996) identifies an important issue to address during transition from appointment to treatment—in the procedure of engaging clients, providers help them identify how their connections to the drug culture prevent them from reaching their goals and how the loss of these connections would affect them if they chose to cut ties with the drug culture.

How To Acquire About Clients' Daily Routines and Rituals

One way to proceeds an understanding of a client'south interest in a specific drug culture is to larn about his or her daily routines and rituals. Keep in mind that there tin can exist different routines on weekends or specific days of the week; ask nigh exceptions to the typical daily schedule.

Materials needed: Weekly agenda.

Instructions:

• To arm-twist information most the client'southward daily activities, use a cue or ballast to initiate this exploration, such every bit a calendar highlighting each mean solar day of a calendar week—Mon through Sun.

• Placing the calendar in front of the client, enquire him or her to describe a typical day, beginning with the time that he or she generally wakes up and building on the morning routines (e.grand., "What does an average morning look like for you?").

• Encourage the client to provide a specific account of his or her routine rather than a general response. Important data can be obtained by request the client nearly feelings or reactions to daily activities as they unfold in the session.

• Subsequently completing an example of an entire day, enquire the client if there are exceptions to this schedule that routinely occur on another mean solar day of the week or during the weekend. Once these are candy, it tin can be benign to ask what it was like for him or her to talk nigh these daily routines.

"The culture of recovery is an informal social network in which grouping norms (prescribed patterns of perceiving, thinking, feeling, and behaving) reinforce sobriety and long-term recovery from addiction."

(White 1996, p. 222)

Finding Alternatives to Drug Cultures

A client can run into the psychosocial needs previously satisfied by the drug culture in a number of means. Strengthening cultural identity can be a positive action for the client; in some cases, the customer's family or cultural peers can serve as a replacement for involvement in the drug culture. This choice is particularly helpful when the client's connectedness to a drug culture is relatively weak and his or her traditional culture is relatively stiff. Notwithstanding, when this option is unavailable or bereft, clinicians must focus on replacing the client'south ties with the drug culture (or the culture of habit) with new ties to a civilisation of recovery.

To help clients pause ties with drug cultures, programs need to challenge clients' connected involvement with elements of those cultures (east.m., style of apparel, music, language, or advice patterns). This tin occur through two basic processes: replacing the element with something new that is positively associated with a culture of recovery (e.g., replacing a marijuana leaf keychain with an NA keychain), and reframing something so that it is no longer associated with drug apply or the drug civilisation (eastward.g., listening to music that was associated with the drug culture at a sober trip the light fantastic with others in recovery; White 1996). The process will depend on the nature of the cultural element.

Developing a Civilization of Recovery

Just as people who are actively using or abusing substances bond over that common experience to create a drug culture that supports their continued substance use, people in recovery tin can participate in activities with others who are having similar experiences to build a culture of recovery. In that location is no unmarried drug culture; likewise, at that place is no single culture of recovery. However, big international mutual-assist organizations like Alcoholics Bearding (AA) practise stand for the culture of recovery for many individuals (Exhibit vi-7). Even within such organizations, though, there is some cultural variety; regional differences exist, for instance, in meeting-related rituals or attitudes toward certain issues (e.1000., use of prescribed psychotropic medication, approaches to spirituality).

Exhibit 6-7

12-Footstep Grouping Values and the Civilisation of Recovery.

The planned TIP, Relapse Prevention and Recovery Promotion in Behavioral Health Services (SAMHSA planned e), provides more than information on using mutual-help groups in treatment settings and in long-term recovery. It contains detailed data almost potential recovery supports that behavioral health programs can use to foster cultures of recovery amid clients and program graduates.

Recovery from mental and substance apply disorders is a procedure of change through which people improve their health and wellness, live in a self-directed mode, and work toward achieving their full potential.

(SAMHSA 2011b)

About handling programs endeavor to foster a culture of recovery for their clients. Some modalities, with therapeutic communities existence the lead case, focus on this issue equally a primary treatment strategy. Even i-on-one outpatient handling programs typically encourage attendance at mutual-help groups, such every bit AA, to see sociocultural recovery needs. Nearly providers as well recognize that clients need to replace the activities, behavior, people, places, and things associated with substance corruption with new recovery-related associations—the key purpose of creating a civilization of recovery.

Fifty-fifty programs that already recognize the need to create a culture of recovery for their clients can brand doing so more of a focus in treatment. White (1996) explores ways to do this, including:

• Teaching clients most the beingness of drug cultures and their potential influence in clients' lives.

• Teaching clients about cultures of recovery and discussing how elements of the drug culture can exist replaced by elements of a civilisation of recovery.

• Establishing clear boundaries for appropriate behavior (e.grand., behavior that does not reflect drug cultures) in the plan and consistently correcting behaviors that violate boundaries (east.g., wearing shirts depicting pot leaves; displaying gang-affiliated symbols, gestures, and tattoos).

• Working to shape a peer culture within the plan so that longer-term clients and staff members can socialize new clients to a culture of recovery.

• Having regular assessments of clients and the entire program in which staff members and clients decide areas where work is needed to minimize cultural attitudes that can undermine treatment.

• Involving clients' families (when appropriate) in the treatment process and so they can support clients' recovery besides equally participate in their own healing process.

White (1996) suggests that programs build linkages with mutual-help groups; include mutual-help meetings in their programs or provide access to customs mutual-aid meetings; and include common-help rituals, symbols, language, and values in treatment processes.

Other activities that can improve integration into a recovery culture include SAMHSA's Recovery Community Services Program (http://www.samhsa.gov/grants/2011/ti_11_004.aspx), which was developed to provide and evaluate peer-based recovery support services, and Recovery Customs Centers, which provide space for recovering people to socialize, organize, and develop a recovery culture (White and Kurtz 2006). Developing a culture of recovery involves connecting individuals back to the larger community and to their cultures of origin (Davidson et al. 2008). This can require efforts to educate the community about recovery as well (e.one thousand., by promoting a recovery calendar month in the community, hosting recovery walks or similar events, or offering outreach to community groups, such equally churches or fraternal/benevolent societies).

Programs that do not take a programme for creating a civilisation of recovery among clients take a chance their clients returning to the drug civilization or holding on to elements of that culture because it meets their basic and social needs. In the worst case scenario, clients will recreate a drug civilization among themselves within the program. In the best case, staff members will have a programme for creating a culture of recovery within their treatment population.

SAMHSA's Guiding Principles of Recovery

• Recovery emerges from promise.

• Recovery is person driven.

• Recovery occurs via many pathways.

• Recovery is holistic.

• Recovery is supported by peers and allies.

• Recovery is supported through relationship and social networks.

• Recovery is culturally based and influenced.

• Recovery is supported by addressing trauma.

• Recovery involves individual, family, and community strengths and responsibility.

• Recovery is based on respect.

More information on the Guiding Principles of Recovery is available at the SAMHSA Store (http://store.samhsa.gov/shin/content//PEP12-RECDEF/PEP12-RECDEF.pdf).

Source: SAMHSA 2012c.

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Source: https://www.ncbi.nlm.nih.gov/books/NBK248421/

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