Wednesday, February 1, 2023

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Substance Abuse in San Bernardino

San Bernardino, a city in Southern California, has an estimated population of 216,239, and serves as the county seat of San Bernardino County. As the 17th-largest city in the state and the 100th-largest in America, this city has diverse demographics: 60 percent Hispanic or Latino, 45.6 percent White, 15 percent Black or African American, and 4 percent Asian. Though the city and county alike, have maintained a relatively healthy economy, environment and populace, the possession of methamphetamine and excessive drinking has risen within the last few years. In 2017, “A 16-month investigation culminated in the seizure of 12 pounds of methamphetamine and 18 weapons as well as 70 arrests” in San Bernardino County. Even more unsettling, this bust involved two local gangs that often recruited youths from local schools and neighborhoods; although many arrests have been made, the threat of meth use and distribution continues.

If you live in San Bernardino, and have fallen victim to substance abuse don’t hesitate to seek treatment. There are enormous resources in at your disposal.

Alcohol Problem in San Bernardino

Compared to San Benito County with 207 DUI charges in 2012, San Bernardino had an alarming 11,586 DUIs that year. Mothers Against Drunk Driving (MADD), reports that, “The rate of drunk driving is highest among 21 to 25 year olds,” (23.4 percent) for this district. Statewide, the 21 to 30 year age group makes up 44.2 percent of DUI charges (DMV, 2012). MADD also claims that, “An average drunk driver has driven drunk 80 times before first arrest”. San Bernardino County had 1,073 alcohol-involved serious collisions in 2014, and California totaled 16,960 (Community Indicators Report). Strikingly, 12 percent of serious collisions in this county involved alcohol, compared to 11 percent of collisions statewide. From 2013 to 2014, alcohol-related crashes increased by 10 percent, whereas California declined by 1 percent.

Furthermore, chronic liver disease and cirrhosis from alcohol abuse has worsened and San Bernardino County has recently had more induced deaths than the statewide average. Resultantly, treatment admissions for alcohol abuse rose by 29 percent in 2014. However, alcohol abuse and dependency continues to cause problems for many residents.

DUI Regulations in San Bernardino

Like many counties in Southern California, DUI offenders in San Bernardino, “Are required to install an Ignition Interlock Device on their vehicle for 5 months, which does not permit one’s car to start unless the driver’s BAC level is under 0.08%” (Tarman & Shamuilian). Additionally, all DUI convictions stay on the DMV’s records for 10 years. First time DUI charges in the district involve: 3 years of summary probation, an approximate fee of $1,906, a three month long drug/alcohol program, and a likely two-day jail time. For each additional DUI, the penalties get significantly worse, therefore its important to plan—pick a designated driver, download an Uber of Lyft app, or choose to sleep over night at the current location.

What is Meth Addiction?

“Meth,” the American Addiction Centers (AAC) claims, “floods the nervous system and penetrates the brain to a far greater degree than amphetamine”. Reportedly, the substance’s effect remains in the patient’s system for much longer than the initial inhalation, “Scrambling and rewriting the brain’s reward and pleasure centers, and sowing the seeds for a painful addiction” (AAC). Highly addictive, crystal meth, forces the brain to pump out dopamine, the neurotransmitter that induces a sense of satisfaction. Pushing the brain to secrete excessive domaine, over time this drug actually destroys dopamine receptors in the brain, causing the user incapable of experiencing pleasure aside from meth. Thus, this substance becomes the user’s main focus in all areas of life (eg social, psychological, and physical).

Signs and Symptoms of a Meth Addiction

Several physical and psychological symptoms of meth use includes:

  • Intense scratching
  • Rotting teeth
  • Weight Loss
  • Irritability
  • Paranoia
  • Acne or sores
  • Confusion

Withdrawal Effects of Meth

According to Acadiana Addiction Center, “Meth detox should always occur in a proper rehab center under the careful eye of trained medical professionals”. Common withdrawal symptoms involve:

  • Anxiety
  • Craving meth
  • Teeth grinding
  • Depression
  • Decreased energy
  • Night sweats
  • Increased sleeping
  • Irritability
  • Weight gain
  • Lack of pleasure
  • Anhedonia
  • Suicidal thoughts

Does Meth Have Long-Term Consequences?

Past chronic abusers of meth may experience psychotic symptoms that last for months or years after quitting, especially during times of stress. Psychotic features include: paranoia, delusions, and visual and auditory hallucinations. Most users will start to feel much better around three to four weeks after withdrawal—sleep, energy levels, and mood stability will improve. For those who’ve used meth longer and more frequently, will more likely endure psychosis every so often.

How to Recognize and Diagnose Alcoholism

One should consider the following when figuring out whether or not an individual has alcohol addiction:

  • Alcohol consumption interferes with work, school, family, and/or other responsibilities
  • Consumption continues despite the negative impact it’s having on one’s relationships
  • Risky behavior results after drinking, such as driving, fighting, or having unprotected sex
  • Needing more alcohol over time to achieve the desired intoxication state

Withdrawal Symptoms from Alcohol

The American Addiction Centers breaks alcohol withdrawal down into three stages. Stage 1 begins 8 hours after the last drink, and involves: anxiety, insomnia, nausea, and abdominal pain. Stage 2 occurs 24 to 72 hours after the last drink, and includes: high blood pressure, increased body temperature, unusual heart rate, and confusion. Finally, stage 3 arises around 72 hours after the last drink, which involves: hallucinations, fever, seizures, and agitation. Since alcoholism usually has underlying mental and psychological factors associated, its important to receive proper treatment after or during withdrawal.

When to Hold an Intervention

For some, addiction may require an intervention. By joining forces with others and taking action through a formal intervention, your loved one will receive a structured opportunity “to make changes before things get even worse, and it can motivate him or her to seek or accept help” (Mayo Clinic). In addition to family and friend involvement, an intervention, includes a consultation with a licensed alcohol and drug counselor, or is directed by an intervention professional. Gathering together, these people collaboratively confront the addicted individual about the consequences of addiction and ask him or her to accept treatment. Typically the intervention points out specific examples of destructive behaviors and instances that the substance-user or alcoholic engaged in that greatly impacted family members and friends. In conjunction with this, the intervention provides a prearranged treatment plan with clear steps, goals and guidelines, and warns what each person will do if the individual refuses to accept treatment (eg break off communication, kick the person out of the house). Notably, careful planning determines whether a successful intervention will occur; by contrast, poor planning  can worsen the situation, as the addicted person may feel attacked and become more detached or resistant to treatment.

Intervention-Steps in Detail:

  • Make a plan: the concerned friend or family member should propose an intervention and form a planning group; a qualified professional counselor/interventionist will help organize an effective intervention; its essential to have expert guidance, as an intervention has potential to cause resentment, anger, or a sense of betrayal.
  • Gather information: With other group members, find out about the extent of the sufferer’s problem and research the condition and treatment programs—perhaps agree on a specific treatment program.
  • Form the intervention team: The “planning group” forms a team of participants for the intervention. This step includes setting a date and location, and working together to construct a consistent, rehearsed message and a comprehensive plan. Notably, the loved one shouldn’t know what’s occurring until the day of the intervention.
  • Decide on specific consequences: If the addict refuses treatment, each person must decide what action he or she will take.
  • Make notes on what to say: Each individual should cite specific incidents where the individual’s addiction caused major problems. However, in doing so, the speaker(s) must also express care and expectation that he or she can change.
  • Hold the intervention meeting: Bring the addicted individual to the intervention site, without revealing the reason. Team members then take turns sharing their concerns and feelings. Afterwards, the addict is presented with a treatment option and asked to accept that option on the spot; meanwhile each member warns the individual what will happen if he or she refuses.
  • Follow up: If all goes well, and the individual goes through with a treatment program, members of the intervention-team should assist them in staying on track in order to avoid relapse. From changing patterns of everyday living, such as ridding of alcohol in the house, to attending counseling meetings with your loved one, healthy changes will avoid destructive behavior.

Whether the indivual gets help through an intervention or by choice, the main aim is to recover from a life dictated by substances.

Steps to a Full Recovery

  1. Detox

            In order to begin a recovery program, the patient must detox— this means, ridding of all toxins in the body’s system by staying clean for at least five to ten days. Usually, rehab programs reject those who aren’t fully detoxed. However, many centers have medically supervised detox programs for those whom struggle to abstain from substance and alcohol-consumption. Detoxing without further therapy, though, will inevitably lead to relapse. Therefore, detoxing is just the first step in a series of phases for full recovery.

  1. Assessment

            For rehabs dealing with any major addiction—meth, heroin, alcohol, other opiates, etc—assessments must take place before accepting a patient. Assessments typically come in the form of questionnaires, self-evaluations, and/or a physical exam. By answering questions and recording health-data, the assessor can accurately determine whether an addiction is fully present, to what extent, whether or not it pairs with co-occurring condition(s), and how to treat the specific, individual. Usually doctors, nurses, social workers, and therapists carry out these assessments. Though assessment strategies may differ from rehab to rehab, all locations carry out comprehensive analyses’.

  1. Intake

            During the intake process, the patient will meet individually with a counselor or therapist, a doctor, and/or a psychologist. Establishing these relationships with the staff helps them communicate with each other to collaboratively develop a methodical treatment plan. Typically, documented notes describing medical and mental health history, will be reviewed from the session(s), and specialized screenings and physical exams might also take place. Additionally, the patient will be asked about major events or certain instances that might have triggered the addiction. Important to note—the intake process usually involves some form of payment and/or a financial plan, and fortunately, many facilities offer a number of payment and insurance options.

  1. Inpatient Treatment

            Residential treatment centers (RTC), are highly structured, and evidence-based programs that typically follow the 12-step model of recovery (Alcoholics Anonymous). Additionally, inpatient rehabs offer emotional process groups—e.g. CBT (for obsessive thoughts and compulsions), DBT (for stabilizing moods), and work-return planning, etc. RTC works especially well for individuals who have recently received hospital-care, or who need more structure, and stability than outpatient care. Average length of stay is typically three to six months, and is usually all residential-based (no returning home each night).

  1. Outpatient Treatment

            Partial hospitalization drug rehab programs (PHP), and intensive outpatient programs for substance abuse (IOP), differ from RTC in that patients go home in the evenings. PHP, also referred to as “day rehab,” provides the patient with the intensity of RTC, but for six hours a day, five days a week. Using many of the same tools and resources, PHP can be just as effective; individuals receive group-therapy, counseling, medical assessment, etc. Due to cost-reduction and flexibility, many drug and alcohol rehab centers now offer this style of treatment.

            Intensive outpatient programs for substance abuse (IOP), offers the same services, but goes for three hours a day, three days a week. Typically, this option suits those who’ve completed an inpatient program, like RTC, or for individuals that require an outpatient setting (due to professional or personal reasons). Additionally, IOP focuses on group therapy, while using one-on-one counseling less often. Length of stay differs from person to person, depending on the individual’s emotional and psychological progress.

  1. Aftercare

            Immediate, and continuous follow-up treatment for substance abuse, should occur after the completion of an initial rehab program. Addiction aftercare programs aim to encourage recovery maintenance, and helps develop ways to prevent relapse, to achieve a fulfilled life with healthy relationships and a sense of purpose. Longstanding substance abuse can de-normalize cognitive-function and altar parts of the brain long after rehab, therefore continuing treatment is extremely important. Beyond physical impact, several long-term psychological changes may affect thoughts, feelings, and behaviors (as another consequence to prior intoxication). Therefore, its essential that aftercare proceeds.

What happens after discharge?

Consider a Sober Living Home

Another idea to consider is living in a sober living home— a group home for addicts, that allows one to come and go as they please, as long as they follow curfew-rules and complete standard chores. Before moving in, the recovering-addict should find a 12-step sponsor (a family member, a friend, or an acquaintance, that will support, listen, and hold you accountable). Once, enlisted, residents in these homes must remain sober, and be willing to support others. Thus, this environment encourages sobriety and helps addicts adjust to a non-substance/non-alcoholic life. Many sober living homes include volunteer opportunities and therapeutic meetings, such as feeding the homeless at soup-kitchens, as well as, Alcoholic-Anonymous (12-Step) gatherings, and job-search planning. Before moving in, each individual must complete the detox process (refer back to step 1 on how to do this).