WIN Minutes 02-24-09
Nenana Wellness Coalition
MINUTES
February 24, 2009
The Nenana Wellness Coalition is an alliance of representatives from various organizations, government agencies, community groups and individuals that meets weekly to discuss, evaluate, coordinate, consolidate, celebrate and help implement plans for improving the wellness and quality of life in Nenana Alaska.
There were 15 in attendance this date, including: Sharon Clark, Barbara Carson, Brian Fisher, Gloria Johnson, Virginia Young, Merrily Verhagen, Bill & Rebecca Troxel, Miles Martin, Kat McElroy, Maryellen Robinson, Tara, Walter & Andrea Tommy and Tim Horn. We had spaghetti and meatballs, spinach salad, 4-grain garlic bread and gluten-free brownies for lunch.
WELCOME: By this week’s chairperson, Rebecca Troxel, followed by the READING OF MISSION STATEMENT
PRAYER: Was lead by Virginia Young, followed by the PLEDGE OF ALLEGIENCE.
PRESENTATION OF AGENDA AND CALL FOR MODIFICATIONS: There were no changes in the agenda.
APPROVAL OF MINUTES: Minutes were submitted electronically to the WIN e-list and posted on the WIN link at www.railbelt.com
INTRODUCTION OF GUESTS: Introductions were made all around. Brian Fisher is the new magistrate for the Nenana District Court. Gloria Johnson is the court clerk.
SPEAKERS/TOPICS
Addiction 101- Kat McElroy explained that she was dry-running this material for a workshop she will be doing at the Community Cares conference in Fairbanks in April. This workshop intends to explore the subtle, and sometimes confusing, differences between substance use, abuse and dependence. Kat wants people to challenge their own understanding of addiction and be receptive to examining personal stereotypes they may carry.
We looked at the DSM-IV criteria for abuse v/s dependence. We discussed the continuum of alcohol and drug use, and the signs and symptoms of addiction. The Jellinek Curve was utilized as a springboard to discuss the processes of addiction and recovery. Lastly, we considered strategies and scripting for talking to children about a parent’s substance abuse or addiction. Please see attached handouts.
Kat used examples from her personal and professional experience to illustrate how substance use, substance abuse and chemical dependence intersect upon that continuum from casual or experimental use to full-blown addiction. She explained why and ways that it is important to be able to differentiate between these issues. She cited research and anecdotal information regarding the nature of true addiction.
Discussion ensued regarding ways we can address individually and collectively as a community the substance abuse that occurs in Nenana and the addiction we witness.
WELLNESS THOUGHT: Everywhere you go, there you are. Anonymous
UPDATES/ANNOUNCEMENTS:
Health Fair Meeting Friday, 10:30 A.M. at the NSLC.
OPEN FLOOR FOR COMMENTS/QUESTIONS/DISCUSSION: There was plenty, primarily regarding our various plans to create sober housing and community-based recovery support services developed from our local resources and without outside grants. Sharon Clark, however, had some excellent suggestions about people within the state, especially the Mental Health Trust, who would be interested in our vision and who may be in a position to provide guidance or technical support. Andrea took notes.
ADJOURNMENT: 2:30 P.M.
Understanding Addiction
Alcohol and drug use occur along a continuum. Not everyone who uses substances is addicted. Levels of use generally are identified as use, abuse, and dependence. An assessment can be conducted to determine a person’s location on the use, abuse, dependence continuum.
Substance use may be non-problematic. One may disapprove, of course, but many people drink alcohol or experience casual use of psychoactive substances without harm. Adolescents often engage in experimental substance use.
Substance abuse is defined as the use of psychoactive substances at times or in ways that: results in legal problems; create social problems; is physically hazardous; or, causes failure to fulfill obligations at work, home or school.
Substance dependence is defined as the use of psychoactive substances that results in at least three of the following: withdrawal, tolerance, loss of control, desire or efforts to stop or control use, preoccupation with use, failure of role obligations, continued use despite physical, or psychological problems created by use.
Addiction to alcohol and drugs may be physical or psychological. Physical dependence refers to physical changes in the body, such as tolerance or withdrawal. The symptoms of physical dependence vary by type of drug used. Psychological dependence refers to the perceived need for the alcohol and drugs to feel good, function, or to keep from feeling bad. People who use substances may use alcohol only, one drug only, a combination of drugs, or a combination of alcohol and drugs. Poly-drug use (more than one drug, or alcohol and drugs combined) is a common pattern of use among substance abusers.
In many states, the number of people treated for alcohol problems equals the number treated for all other drugs combined..
How much is too much? One should be concerned about the risk of alcohol addiction if a woman drinks more than seven drinks a week or three drinks at a time. For men, the level is 14 drinks per week, or four per occasion.
Alcohol and drug addiction are diseases that, while treatable, are chronic and relapsing.
What does this mean? This means that over time, the disease of addiction causes changes in the person’s body, mind, and behavior, and that a person is unable to control his or her substance use, despite the harm that results. Chronic and relapsing mean that the addiction is never “cured,” and that substance use may persist or reappear over the course of an individual’s life.
The most important questions to ask are, “How does drinking (or other drug use) affect the person’s ability to make sound judgments?” and, “What behaviors are resulting or have resulted from the person’s alcohol or other drug use?”
Symptoms of Addiction
There are many symptoms related to drinking problems. Alcoholism is considered a progressive disease, meaning that the symptoms and effects of drinking alcohol become increasingly more severe over time. Those who use alcohol may begin to show early signs of a problem, then progress to showing symptoms of alcohol abuse; if drinking continues, they may later show symptoms of alcoholism or alcohol dependence.
Early Signs of a Problem
Early signs of alcoholism include frequent intoxication, high tolerance, an established pattern of heavy drinking and drinking in dangerous situations, such as when driving. Other early signs of alcoholism include black-out drinking or a drastic change in demeanor or personality while drinking, such as consistently becoming angry or violent.
Symptoms of Alcohol Abuse
The main symptom of alcohol abuse occurs when someone continues to drink after their drinking reaches a level that causes recurrent problems. Continuing to drink after it causes someone to miss work, drive drunk, shirk responsibilities or get in trouble with the law is considered alcohol abuse.
The Diagnostic and Statistical Manual of Mental Disorders, IV, defines alcohol abuse as drinking despite alcohol-related physical, social, psychological, or occupational problems, or drinking in dangerous situations, such as while driving. The World Health Organization’s International Classification of Diseases refers to “harmful use” of alcohol, or drinking that causes either physical or mental damage in the absence of alcohol dependence. In other words, alcohol abuse is any harmful use of alcohol.
Symptoms of Dependence
For someone who is alcoholic or alcohol dependent, the symptoms include all of those associated with alcohol abuse (above). But alcoholics also continue to drink in spite of all the problems it has caused in their lives. When alcohol abuse reaches the alcohol dependence stage, the person also experiences at least three of seven other symptoms, including neglect of other activities, excessive use of alcohol, impaired control of alcohol consumption, persistence of alcohol use, large amounts of time spent in alcohol-related activities, withdrawal symptoms and tolerance of alcohol.
• Neglect of other Activities: Important social, occupational, or recreational activities are given up or reduced because of alcohol use;
• Excessive Use: Alcohol is consumed in larger amounts over a longer period than intended;
• Impaired control: Ongoing, unsuccessful efforts to cut down or control alcohol consumption;
• Persistence of Use: Alcohol consumption is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely caused or exacerbated by alcohol;
• Large Amounts of Time Spent in Alcohol Related Activities: A great deal of time is spent in activities necessary to obtain, use or recover from the effects of alcohol;
• Withdrawal: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety when alcohol use is stopped after a period of heavy drinking;
• Tolerance: The need for increasing amounts of alcohol in order to feel its effects.
Diagnostic Criteria
(DSM-IV-TR, The American Psychological Association, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision)
Abuse of alcohol or drugs includes at least one of these factors in the last 12 months:
• Recurrent substance use resulting in failure to fulfill obligations at work, home or school
• Recurrent substance use in situations that are physically hazardous
• Recurrent substance-related legal problems
• Continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the substance
Dependence, also known as addiction, is a pattern of use that results in three or more of the following symptoms in a 12 month period:
• Tolerance—needing more of the drug or alcohol to get “high”
• Withdrawal—physical symptoms when alcohol or other drugs are not used, such as tremors, nausea, sweating, and shakiness
• Substance is taken in larger amounts and over a longer period than intended
• Persistent desire or unsuccessful efforts to cut down or control substance use
• A great deal of time is spent in activities related to obtaining the substance, use of the substance or recovering from its effects
• Important social, occupational, or recreational activities are given up or reduced because of substance use
• Substance use is continued despite knowledge of persistent or recurrent physical or psychological problems caused or exacerbated by the substance
Diagnosis of Addiction
Many times, determining whether someone is an actual alcoholic or not is really not all that important. If someone’s drinking and drugging has advanced to the point to where it has become a problem for them and those around them, then it is a problem, period. If the person has tried to quit — swore to themselves and others “never again!” — and simply cannot stop, then chances are they have become dependent or addicted.
Alcohol problems occur at different levels of severity, from mild and annoying to life-threatening. Although alcohol dependence (alcoholism) is the most severe problem, less severe drinking problems can also be dangerous. The term “alcoholism” refers to a disease known as alcohol dependence syndrome, the most severe stage of a range of drinking problems.
Alcohol problems occur at different levels of severity, from mild and annoying to life-threatening. Although alcohol dependence (alcoholism) is the most severe problem, less severe drinking problems can also be dangerous. The term “alcoholism” refers to a disease known as alcohol dependence syndrome, the most severe stage of a range of drinking problems.
Because alcoholics are likely to deny or minimize the amount of alcohol they consume, most alcohol screening tests ask questions about problems usually caused by excessive drinking, rather than ask about how much the person drinks. More and more short tests have been developed in recent years so they can be easily administered in busy healthcare settings.
The TWEAK Test
1. How many drinks does it take to make you feel high?
2. Have close friends or relatives worried or complained about your drinking in the past year?
3. Do you sometimes take a drink in the morning when you first get up?
4. Has a friend or family member ever told you about things you said or did while you were drinking that you could not remember?
5. Do you sometimes feel the need to cut down on your drinking?
Scoring the TWEAK Test The maximum score on the test is seven points, with the first two questions counting for two points each and the last three one point each. Note about question 1: If a woman responds that it takes three or more drinks to feel high, she scores two points. If she responds “less than three,” she scores zero on the question. A total score of two or more on the test is an indication of harmful drinking and further evaluation is indicated.
Some may substitute the following for question 1: “How many drinks can you hold?” If a woman responds that she can hold more than five drinks (meaning she can drink more than five without passing out), she scores two points; she scores zero if she reports less than five.
What to Tell Children About a Parent’s Addiction
How to Talk to Children About Family Substance Abuse Children living in homes where there is parental substance abuse can find life difficult, unpredictable and confusing. Sometimes they even believe the alcohol or drug abuse is their fault. Dealing with the chaos and unpredictability of their home life, children can receive inconsistent messages. They can feel guilt and shame trying to keep the family “secrets.” Often they feel abandoned due to the emotional unavailability of their parents.
What to Tell the Children? If the family breaks up because of substance abuse, or if the children are removed from the home, some become withdrawn and shy while others can become explosive and violent. They often develop issues with self-esteem, attachment, autonomy and trust. What do you tell children when one or both of their parents are alcoholics or addicts? How do you explain the chaos? First and foremost, because trust is almost always an issue, you tell them the truth. According to the National Center on Substance Abuse and Child Welfare, these are the messages that children, with parents who are alcoholics or addicts, need to hear:
Addiction Is a Disease Children need to know that their parents are not “bad” people, they are sick people who have a disease. When they are drunk or high, sometimes parents can do things that are mean or things that don’t make sense.
It’s Not Your Fault Children must understand that they are not the reason a parent drinks too much or abuses drugs. They did not cause the addiction and they cannot stop it.
You Are Not Alone Children need to realize that their situation is not unique and they are not alone. Millions of children have parents who are addicted to drugs or who are alcoholics. They need to know that even in their own school, there are other children in the same situation.
It’s Okay to Talk Children in homes with substance abuse need to know that it’s okay to talk about the problem, without having to feel scared, ashamed or embarrassed. They no longer have to lie, cover up and keep secrets. They should be encouraged to find someone that they trust — a teacher, counselor, foster parent, or members of a peer support group such as Alateen.
The Seven Cs The National Association for Children of Alcoholics suggests that children dealing with family addiction learn and use the following “7 Cs of Addiction:”
I didn’t Cause it.
I can’t Cure it.
I can’t Control it.
I can Care for myself
By Communicating my feelings,
Making healthy Choices, and
By Celebrating myself.
Children from homes where there is parental substance abuse are often scared, lonely and many times feel isolated from society. Whether you deliver the message perfectly or not, giving them someone with whom they can talk is an important step in their recovery.