Individuals in the clinical population of interest
Substance abuse includes use of drugs such as cocaine, heroin, and opioids, and other substances such as alcohol, amphetamines, benzodiazepines, and barbiturates. Often use of these substances leads to criminal ramifications since they are outlawed in many states alongside possible social, physical, and psychological consequences from their use. They also lead to antisocial behaviors and may lead to dependency on the drug by the user.
It is estimated that substance abuse is common in 120 million persons using hard drugs and other substances. The age of these users ranges from the early age of 14 onwards with reports suggesting that close to half of students in the 12th grade have used illegal drugs at some point in their lives. Common drugs among these young users are alcohol and cigarettes of tobacco.
The World Health Organization (WHO) estimates that there are over half a billion people struggling with problems that result from use of substances, especially alcohol while close to two hundred million people are dependent on these substances. The numbers for each drug show a similar trend. It is estimated that over 50 million people are direct users of heroin and cocaine suggesting the use of these drugs is extremely high.
Use of these drugs and substances among illegal immigrants is also high. It is estimated that there are more than 13 million illegal immigrants in the United States with some reports suggesting they could be as many as 25 million. It is believed that more than half of the illegal immigrants, especially those from Mexico Segovia & Defever, 2010()
, are users of illicit drugs and substance. Use of these drugs and substance among illegal immigrants from Asia, Europe, Canada, Africa, and Asia is also high. The state of California, which houses the most illegal immigrants estimated at 3 million, is also thought to be the state with the most burden from use of illicit drugs and substances.
Majority of the users of these illicit substances do so for many reasons. First is as a scape goat from their problems. Users of illicit substances often feel the need to escape from the reality of problems, lack of jobs, political oppression in their home country, loss of relatives, family, or friends. These illicit substances, which give hallucinations as side effects, help them escape this reality and experience a world without problems though only for a short period. When this effect fades, they feel the need to use more drugs to keep the hallucinations going.
The second reason is as a result of peer pressure. It is estimated that three in every four teenagers who has used drugs or illicit substances before does so to fit in with their peers. They see drug and illicit substance use as 'cool' and as a prerequisite for acceptance into their desired social groups. Therefore, they use these substances for this reason. Other teenagers also use illicit substances as a form of experiment to 'see what it feels like' to use these substances. Others may use it as a form of rebel against their parents while others may see the use of drugs such as alcohol as a sign of being grown up and being able to make their own choices. These are some of the reasons why teenagers use drugs.
Substance abuse amongst homeless people is also a huge issue. It is estimated that four in every ten homeless people are dependent on alcohol with another three being users of other hard drugs. Use of alcohol is more common in the older generations compared to the younger generation, which often has to rely on harder substances to get the desired effect. A survey conducted in 2007 suggests that two out of every three homeless people report substance abuse as the reason they are homeless. They report becoming dependent on these drugs and substances and spending too much that they lost everything that they had. Some reported having high flying careers and losing these to drugs and substance abuse.
People who abuse these substances are discriminated in the society as being ill-mannered, disrespectful, and unable to cope with reality. While these are truths stemming from their stupor from using these substances, they are discriminated for this reason. They also face discrimination from alienation. They become estranged from families and friends and it is also difficult for them to make new friends.
Persons involved with drug use and abuse are also discriminated against several opportunities, especially in the workplace. They are often denied positions by virtue of being drug users and judgments or impressions are made about them through being involved with drug use. Mandatory drug tests in the workplace, schools, or other places such as hospitals also lead to discrimination against these individuals since they are viewed as being unreliable and often prosecuted.
Significant barriers to seeking social work treatment
Persons who abuse drugs and other substances experience different barriers to seeking social work treatment. Social workers and psychiatrists discriminate against drug users because they require patience, special interventions and often relapse. This makes seeking social or psychological care difficult for these individuals. Secondly, persons who use illicit drugs fear that social workers are legally required to report any persons who are committing a civil or criminal offence to the police. Being users of illicit substances, regarded as a criminal offence in many states will get these individuals prosecuted. However, many of these users of substances endure traumatic experiences, which are often the reason for their dependence on these illicit substance and needs to be talked through and relieved by a social worker. Other members of the family and friends are also affected by the use of illicit substances by the individual and would benefit from social work being carried on the user.
As a result of frequent relapse, a barrier to access to social treatment arises. Breaking an addiction, especially of illicit substances, is difficult. These individuals who use these illicit substances also do not have sufficient motivation to stop using these substances. For them, using these substances is essential for their personal growth and development compared to the situation without drugs. Therefore helping them recover from substance abuse is difficult and a lot of social workers are demotivated by this.
For many users of these substances, mental illness occurs. This also creates a barrier to access to social treatment because they are unable to comprehend different aspects with ease and many a times are prone to antisocial behaviors that lead them to violence and other risky behavior. Attempting social treatment prior to dealing with the underlying mental illnesses is often ineffective and a waste of time and resources.
Access to social treatment is also limited by the fact that sale of these illicit substances is associated with illegal activities such as criminal gangs. These individuals thus usually fear that their involvement with social treatment will mean they will rat out the members of the criminal gangs thus creating feelings of nervousness, anxiety, fear. anger, depression, and often, social isolation since they do not have a sense of belonging. Therefore, access to social treatment is hindered greatly.
Even while dealing with this population, continued participation in treatment is not guaranteed because their situation often changes rapidly, which increases their psychosocial stressors considerably. Drug substance abusers often have to find new sources of their drugs as a result of their current sources relocating, changing prices, or fall outs with suppliers. Therefore, even when they start receiving treatment, they often do not complete it because of these issues they face.
The media has also been criticized for stigmatizing the users of illicit drugs. This creates a psychological burden on them because the media tries to document their daily experiences, actions, and perception, especially those involved with selling these drugs and substances. This has often led to generalization of all users of illicit substances as criminals without understanding the background of their fall into the use of illicit substances.
To assist a client who uses illicit substances to overcome the barriers to access to treatment requires the social worker to first identify their personal biases towards this population. The counselor must be able to provide practical support and guidance to the individual through the treatment and to achieve this, they should do some self-searching to identify and evaluate their position in regards to users of illegal substances Ponterotto, 2009.
Issues affecting users of these substances are often sensitive and the counselor should be able to understand these feelings and empathize with the client Marbley, 2011.
This can only be achieved by identifying their personal biases towards users of illegal substances (Sue & Sue 2008)
After identifying the personal biases, the counselor can help the client overcome these barriers by assuring them of confidentiality and anonymity throughout the treatment Hays & Erford, 2013.
The social worker should also assure the client that they will not be reported to the police…