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Crisis Intervention Team Training 11_28_16

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Addiction is a Behavioral Health Condition: Supporting CITOfficersto Surpass SUD Stigma

CIT Overview
Memphis ModelTri-County CITNatural Progression of curriculum based on evaluations
Officers’views of Substance Use Disorder that have led to this presentation
Would benefit from more time spent with people suffering from mental illness rather than drug (recovered) addict, in my opinion.Poor,___story not exactly what we were focused on. Seemed more of a substance abuse problem vs. mental health issuesNot sure that I need to hear from a drug addict who is proud of his dealings with law enforcement.Police officers deal with substance users on a day to day basis. With that said, she had a lot of information but, in many ways it felt at times, as though the module was more about her programs future. Rather than direct relation to CIT.Don’t care for the soft glove attitude approach.. leave out the liberal attitude.Confusion onwhat’swhat. On street level crackhead is a crackhead. LEO’s only need recognize disorder likely not legal/proper terminology
Stigma – Creates a barrier to Engagement
Stigma affects people with alcoholism in two ways: externally— through rejection by friends, relatives, neighbors, and employers; and internally—through aggravated feelings of rejection, loneliness, and depression. —CoscoA. Williams, Veterans Health Administration, Atlanta,GeorgiaMany people believe that addiction is a moral problem and that people with substance use disorders choose to continue using drugs. Unlike people with other chronic health conditions, those in recovery from addiction are blamed for their problems. This stigma creates shame, guilt and fear, which prevent millions of people from getting the treatment they need to recover.
Stigma video
Stigma video
Short Activity
What the Public sees about addiction
“crazy drug addict overdoses on public sidewalk”“drug induced zombie walk”“tweekers”FACE of Meth campaign“People High as F*&% compilations”Funny Drunk People Fail compilations”Top 10 funniest Drunk people compilation”COPS/JAIL
Faces of Addiction
Definitions presented to LE
NEW: DSM 5 Substance Use Disorder- a single disorder, measured on a continuum from mild to severe, that combines the DSM IV abuse and dependence criteria with the following two exceptions.Recurrent legal problems has been removedNew criterion for craving or a strong desire or urge to use has been added.Each specific substance is addressed as a separate use disorder; alcohol use disorder, opiate use disorderSubstance Use Disorder is accompanied by criteria for intoxication, withdrawal, substance/medication-induced disorders and unspecified.Severity of SUD is based on 2-3 Mild disorder; 4-5 Moderate disorder; and 6 or more Severe Disorder
Definitions presented to LE
This helps define SUD as a continuum and removes confusion regarding dependence with “addiction” when in fact dependence can be a normal body response to substance.Co-occurring is defined as having two primary diagnoses. This could be a Mental Health Diagnosis, such as schizophrenia and also a Cognitive Impairment, such as autism; or a Substance Use Disorder severe and a Mental Health Disorder, such as Bi-polar disorder. Both disorders need to be addressed in treatment, not separate. Hence the term; Behavioral Health, which includes Mental Health, Developmental disabilities/Cognitive Impairment and SUD.Most substances when used to the severe level mimic mental health disorders.
It’s all about the Brain
ALL Drugs and alcohol stimulate the Brain’s reward system (Dopamine)The MedialForeBrainBundle (MFB) or mesolimbic dopamine system includes; inhibitory control; reward; motivation/drive; memory/learning.This system is known as the pleasure pathwayBrain research is pointing to a genetic componentPrevalence if parent or grandparent usedSome current research looking at generational component linked with opiate dependence – more of a link to having a medical disorder/diseaseAlso looking at genetics with regards to satiation, genetic reduction in brain chemistry, etc.
Brain Chemistry
The Trauma-AddictionConnection
Whileexperiencing a trauma doesn’t guarantee that a person will develop an addiction, research clearly suggests that trauma is a major underlying source of addiction behavior. These statistics (culled from a report issued by the National Center for Post-Traumatic Stress Disorder and the Department of Veterans Affairs) show the strong correlation between trauma and alcohol addiction:Sources estimate that 25 and 75 percent of people who survive abuse and/or violent trauma develop issues related to alcohol abuse.Accidents, illness or natural disasters translate to between 10 to 33 percent of survivors reporting alcohol abuse.A diagnosis of PTSD (post-traumatic stress disorder) increases the risk of developing alcohol abuse.Female trauma survivors who do not struggle with PTSD face increased risk for an alcohol use disorder.Male and female sexual abuse survivors experience a higher rate of alcohol and drug use disorders compared to those who have not survived such abuse.Similar research linking trauma and addiction exists for other habitual behaviors, including drug abuse and eating disorders. Delving deeper into the trauma-addiction connection reveals addiction as part of an extended post-trauma coping mechanism.
Trauma Informed Care
The role of Trauma and Addiction
Relapse & Recovery
Drug addiction can be treated, but it’s not simple. Addiction treatment must help the person do the following:stop using drugsstay drug-freebe productive in the family, at work, and insociety
Anti-Change language
Change is motivated bydis-comfort. Ifyou can make people feel bad enough, they will change. they will change.Peoplehave to “hit bottom hit bottom ” to be ready for to be ready forchangeCorollary:Peopledon’t change if theyhaven’tsufferedenough
Understanding Recovery &Relapse
Successful treatment has several steps:detoxificationbehavioral counselingmedication (for opioid, tobacco, or alcohol addiction)evaluation and treatment for co-occurring mental health issues such as depression and anxietylong-term follow-up to prevent relapse
Rat Park
Great site!
Law Enforcement Perspective
Cops and humor
Counterpoint through Humor
Barriers to Communication
Weigh the obligation to protect the individual from harm against the individuals immediate personal libertiesIs the person capacitated or incapacitatedMedical risk
The crucial attitude is one ofacceptanceSkillful reflectivelistening isfundamental tothe client feeling understood and caredaboutClientambivalence isnormalDemonstratean understandingof the individual’sperspectiveLabellingisunnecessary
How to Motivate
Motivation for change can be fosteredbyan accepting, empowering, and safeatmosphereOfferADVICERemoveBARRIERSProvideCHOICEDecreaseDESIRABILITYPractice EMPATHYProvide PositiveFEEDBACKClarifyGOALSActive HELPING
New LE approach
Handouts for LE after presentation
Local resourcesGood to have a hub, or contact LE can reach outAcknowledge that working with individuals with SUD can be frustrating; no locked units; bed availability
Contact Information
Ericanne Spence;[email protected]; 517-676-4905Melissa Misner;[email protected]; 517-346 -9568LeeMcCallister;[email protected];517-483-4611Jessica Martin;[email protected]; 517-432-0108Darin Southworth;[email protected];517-483-6804Tri-county CIT;
Video References
Stigma of Addiction Informed Care Park and Humor Law Enforcement





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Crisis Intervention Team Training 11_28_16