Effective: Early Spring 8-Week 2017/2018

HUMS 380: Substance Abuse

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  Course Description

Examination of substance use and abuse and the progressive nature of addiction. Factors leading to regular and problematic use are explored. An overview of the pharmacological effects of drugs within major drug categories, theories of addiction, intervention, treatment methods and prevention are examined.

Prerequisite: Sophomore standing.

Proctored Exams: None



  Textbooks

Required

  • Doweiko, H.. (2015). Concepts of Chemical Dependency (9th ed.). Cengage Publishing.
    • [ISBN-978-1-285-45513-6]

MBS Information

Textbooks for the course may be ordered from MBS Direct. You can order

For additional information about the bookstore, visit http://www.mbsbooks.com.

  Course Overview

The course is an examination of substance use and abuse and the progressive nature of addiction. Factors leading to regular and problematic use are explored. An overview of the pharmacological effects of drugs within major drug categories, theories of addiction, intervention, treatment methods and prevention are examined.

  Technology Requirements

Participation in this course will require the basic technology for all online classes at Columbia College:
  • A computer with reliable Internet access
  • A web browser
  • Acrobat Reader
  • Microsoft Office or another word processor such as Open Office

You can find more details about standard technical requirements for our courses on our site.

  Course Objectives

  • To summarize the various pharmacological, psychological, social and emotional effects of drugs within major drug categories
  • To understand the major theories of addiction and models of chemical dependency
  • To understand the process of intake and intervention
  • To explore the substance abuse treatment system and treatment methods

  Measurable Learning Outcomes

  • Explain the major theories of etiology of addiction.
  • Describe the physiological and psychological effects of alcohol and other drugs, both short and long term.
  • Describe the impact of alcohol and other drugs on the family
  • List and describe the various signs and symptoms used for assessing addiction
  • Explain historical and cultural developments in regards to alcohol and other drugs.
  • Define the major terms/language specific to the chemical dependency field.
  • Compare and contrast the strengths and shortcomings of two or more treatment methods.

  Grading

Grading Scale

Grade Points Percent
A 900-1000 90-100%
B 800-899 80-89%
C 700-799 70-79%
D 600-699 60-69%
F 0-599 0-59%

Grade Weights

Assignment Category Points Percent
Discussions (16) 240 24%
Essays (4) 260 26%
Midterm Exam (1) 250 25%
Final Exam (1) 250 25%
Total 1000 100%

  Schedule of Due Dates

Week 1

Assignment Points Due
Discussion 1: Introduction 15 Thursday/Saturday
Discussion 2: Diagnosing Alcohol Disorders 15

Week 2

Assignment Points Due
Discussion 3: Should you intervene? 15 Wednesday/Saturday
Discussion 4: Data Privacy 15
Essay 1 50 Friday

Week 3

Assignment Points Due
Discussion 5: Biopsychosocial model of addiction 15 Wednesday/Saturday
Discussion 6: Harm Reduction 15

Week 4

Assignment Points Due
Discussion 7: Information Sources 15 Wednesday/Saturday
Discussion 8: CNS Stimulants 15
Essay 2 70 Friday
Midterm Exam 250 Sunday

Week 5

Assignment Points Due
Discussion 9: Narcotic Addiction 15 Wednesday/Saturday
Discussion 10: Enabling 15
Essay 3 90 Friday

Week 6

Assignment Points Due
Discussion 11: Co-occurring Disorders 15 Wednesday/Saturday
Discussion 12: Prevention 15
Essay 4 50 Friday

Week 7

Assignment Points Due
Discussion 13: Gender Specific Rehab 15 Wednesday/Saturday
Discussion 14: Cross-Cultural Diagnosis 15

Week 8

Assignment Points Due
Discussion 15: Medication-Assisted Treatment 15 Wednesday/Saturday
Discussion 16: Relapse 15
Final Exam 250 Saturday
Total Points: 1000

  Assignment Overview

Discussions

Each week you will participate in two online discussions to deepen your understanding of the course topics. Your initial post should answer all discussion questions thoroughly and is due by 11:59 pm Thursday in Week 1 and Wednesday in Weeks 2-8. In addition, at least three responses to either your classmates or instructor are required per discussion. Responses are consistently due by 11:59 pm Saturday. Discussion settings will not allow you to read others' posts before you have submitted your initial post. Discussions are worth 15 points.

Your post should be written in your own words, without quoting any sources. Posts including direct quotes will lose points. If you reference any source, you should paraphrase the material and it must be cited. Writing is expected to be at college level using correct grammar and punctuation.

Your responses to others’ posts should also be well developed, fully explaining your response to the classmates’ posts. Make responses that add to the conversation and take it further; simply posting “I agree” or “good job” does not help develop ideas. For maximum learning and point benefits, respond to at least three students’ posts.

Grading criteria will be available in the course Content area.

Essays

There are four Essay assignments in the course that allow you to explore designated topics in depth. You are expected to write professionally with correct spelling, punctuation, and grammar, developing your topic and providing solid examples from our readings, your own research, or your own experiences to back up your statements. APA style must be used in Essay 3 and 4. All papers are due by 11:59 pm on Friday of the week they have been assigned. The point values vary by essay, but ranges from 50-90 points. See the course Content area for additional instructions and detailed grading criteria.

Midterm and Final Exams

There will be both a Midterm and Final Exam in the course. Both consist of 50 objective-type questions. You have one attempt at each and will be timed at 60 minutes. Neither is proctored. The Midterm covers week's 1-4 materials and the Final covers week's 5-8 materials.  See the course Content area for additional details.

  Course Outline

Click on each week to view details about the activities scheduled for that week.

Readings
  • Doweiko: chapters 2, 3, 4, 5, 16, and appendix 5
  • Lecture: Scope of the Problem and Introduction to the Course
  • Video: Nicotine Addiction and Molecule Diffusion

    Note: Learning resources (other than the textbook) listed throughout the syllabus will be located in the Content area of the course.
Discussion 1: Introduction

Please introduce yourself to the class. Information to include might be your location, your year in school, your family, and hobbies. Help us get to know you!

Also share your thoughts on the assigned video, “Nicotine Addiction and Molecule Diffusion.” What role does the brain have in addiction?

Discussion 2: Diagnosing Alcohol Disorders

There are few who would argue that alcohol use disorders do not cause terrible damage, both to drinkers’ bodies and to their social world. The physical damage associated with alcohol abuse and addiction is discussed in your text. However, at what point do we say that a person definitely has an alcohol use disorder? The end-stage alcoholic can be easy to recognize. However, the high-functioning alcoholic is not always as easily identified.

Imagine that you will two different individuals. One is the vice president of a major corporation, in his or her early 60s, earning a salary well into the six-figure range, and married with two children who have completed college and have started their own lives. This individual belongs to a country club, owns a rather large recreational boat, and since the house mortgage is paid off, is well-off and comfortable. This person also consumes 3-4 glasses of an expensive brand of liquor each evening after dinner and is in good health.

In contrast to this scenario is a second hypothetical person who drinks beer. This person goes to a favorite bar 3-4 nights a week and also has a sizable supply of beer bottles in the refrigerator at home. This person earns about $20,000 a year, and his or her spouse has to work to supplement the family income. They have two children, one of whom has been arrested for “underage consumption” of alcohol on four different occasions in the past, and once for driving under the influence of alcohol. Our hypothetical worker is also about 60 years of age and consumes 4-6 twelve-ounce bottles of beer in a 6-hour time span after work. This person has also been diagnosed with stenosis of the liver, probably induced by drinking, according to the physician who made the diagnosis, and has been arrested for driving under the influence of alcohol on two separate occasions (but not in the last decade).

Questions

  1. Would you suggest that one or the other did not have a drinking problem? Why or why not?
  2. What information do you believe is needed to diagnose an individual with an alcohol use disorder? Does economic status alter the individual’s diagnosis? Should economic status influence the diagnosis? Why or why not?
Readings
  • Doweiko chapters 10, 13, and 27
  • Lecture: The DSM
  • Web: MAST screening tool
  • Web: DAST screening tool
  • Web: CAGE and AUDIT screening tools
Discussion 3: Should you intervene?

Imagine that you walk into the garage to retrieve a tool and stumble upon a younger sibling engaged in the practice of abusing an inhalant. Should you intervene? You are not the child’s parent.  A counter-argument is that now that you know the dangers of inhalant abuse, a delay might result in organ damage to your sibling. If, in the hypothetical example discussed above, the child were a half-sibling or step-sibling, would your response to this discovery be any different? Why, or why not?

Note: The due dates for discussions changes to Wednesday/Saturday this week!

Discussion 4: Data Privacy

The privilege of confidentiality remains with the client, except under special circumstances, as noted in your text. Imagine that you are a counselor in a clinic that treats addiction. Your client refuses to sign a Release of Information authorization to the courts until he or she is able to review your assessment to make sure that it is favorable. How would you handle such a situation?

Essay 1

How does one become qualified to be an addictions professional? This assignment will help you determine those steps by examining your particular state’s requirements. You will outline the necessary steps toward licensure and/or certification in this essay. Answer the following questions in an approximately 2-page, double-spaced paper. Use your own words and do not simply copy and paste from the site. This essay is worth 50 points.

  1. Provide a link to your state’s professional credentialing board.
  2. Identify where you are in the process towards certification.
  3. What are you qualified to do at this present moment? What will you be qualified to do when you have a bachelor’s degree?
  4. What are the requirements for the highest credential in your state?

See the Content area of the course for additional information.

Readings
  • Doweiko: chapters 6, 7, 25, 29, and 30
  • Lecture: Treatment and Medical Insurance Constraints
Discussion 5: Biopsychosocial model of addiction
How does the biopsychosocial model of addiction compare to your personal beliefs about how addiction occurs? Reference chapter 25 (and any supplemental material you wish to use) in your post.
Discussion 6: Harm Reduction
In your text, the concept of Harm Reduction (HR) was introduced. A central tenet of the HR model is that it is impossible to prevent substance abuse, but that it is possible to limit the impact of substance abuse or addiction on society, at least to some degree. Having a “designated driver” or taking a taxicab home after a night’s drinking can be viewed as a form of harm reduction. Through these provisions, intoxicated persons are at least not driving a motor vehicle under the influence of alcohol, thus reducing the risk to other drivers. Such provisions also avoid the possibility of legal sanctions against the drinker for driving a motor vehicle under the influence of alcohol or the financial costs that accrue from such sanctions (bail, attorney's fees, court costs and fines). Other examples of harm reduction were discussed in your text, such as needle exchange programs. Such programs limit the transmission of infections such as HIV, the virus that ultimately causes AIDS. Do such programs promote the use of alcohol or illicit drugs, or just limit the harm forced upon society through the abuse of these chemicals? Please explain your answer.
Readings
  • Doweiko: chapters 8, 9 and p. 447
  • Lecture: Motivational Interviewing
  • Pamphlet: Enhancing Motivation for Change in Substance Abuse Treatment (you will need to use the M.I. worksheets included to complete Essay 2 this week.)
Discussion 7: Information Sources
What is your main source of information for learning about drugs and their effects? Do you trust the source? What makes a source trustworthy? What are some sources you might use in the future to get the most accurate information possible? Please include links to journals and websites you find.
Discussion 8: CNS Stimulants

The Durham-Humphrey Amendment to the Food, Drug, and Cosmetic Act of 1938 was passed in 1952. This amendment defined a pharmaceutical as a compound that required a physician’s prescription before it could be dispensed through a licensed pharmacy. Ephedrine was defined as an over-the-counter agent for the treatment of such conditions as nasal congestion. The CNS stimulatory effects of ephedrine, especially when this compound was abused by long-distance truck drivers, or students attempting to “cram” for final examinations, were quietly ignored because these effects were achieved only when ephedrine was ingested in larger-than-recommended doses.

As your text has indicated, however, ephedrine is capable of producing dangerous, potentially life-threatening, side effects. It is also the core molecule that chemists use to manufacture illegal methamphetamine, although its chemical cousin pseudoephedrine is also used for this purpose on occasion. (Pseudoephedrine was originally developed in an attempt to retain the medical action of ephedrine, but to limit its abuse potential. This effort failed.) For a long time methamphetamine for illicit use was produced in small “mom and pop” laboratories for local consumption. With the increasing restrictions on ephedrine and pseudoephedrine, methamphetamine is now usually produced in “super-labs” outside of this country and then smuggled into the US. If the efforts to control methamphetamine production have failed, should the restrictions on access to ephedrine or pseudoephedrine be lifted? Why or why not?

Essay 2
Interview a partner about something they might want to change about himself, using one or two of the M.I. worksheets (found in Enhancing Motivation for Change in Substance Abuse Treatment -- pp. 100, 138, 142 and/or 226). Discuss how this technique worked in terms of reducing resistance to change. How was it for you to interview someone about change? Include the worksheet/s with your assignment. You can take a picture of the worksheet and if that is easiest for you. Minimum length is 2 pages, plus an additional page(s) containing the completed worksheet. The essay is worth 70 points.  See the Content area of the course for additional information.
Midterm Exam
The Midterm covers materials assigned in weeks 1-4. It has 50 objective questions. You have 1 attempt, and will be timed at 60 minutes. It is worth 250 points and must be completed by 11:59 pm Sunday.
Readings
  • Doweiko:  chapters 11, 22 and 23
  • Lecture: Codependency and Enabling
Discussion 9: Narcotic Addiction

Assume that you are a physician, treating a patient who is terminally ill with cancer. As the cancer progresses, and as neuroadaptation to the narcotic analgesic develops, you have increased the patient’s daily medication dose to the point that you are starting to worry about causing the person to become addicted to these medications. This patient has no prior history of alcohol or drug addiction, although many members of the patient’s family have substance use disorders. You have the choice to order dosage increases as warranted, or hold the patient at the present level to avoid the danger of iatrogenic addiction. A moral question is whether the physician should worry about inducing an addiction in a patient who will soon expire from a disease process such as cancer.

Questions

  1. What would you do in this situation? Why?
  2. What are the various factors that need to be taken into account in this case? What does your answer to question 1 imply about which of these factors is the most important?
  3. Now imagine that the patient has a prior history of a substance use disorder and of poor compliance with treatment. Should you refuse to administer narcotic analgesics for such a patient who is living at home? What would be the reasoning behind either choice?
  4. How can the physician identify legitimate pain from addictive behaviors? Should the doctor rely on the patient’s word, or should the physician order urine toxicology testing to confirm the presence of prescribed medications?
Discussion 10: Enabling
Consider the following hypothetical situation. You know that your friend is an who frequently drinks away the family funds at the bars. The spouse of this friend asks for a loan of $1,500 to pay the monthly bills and put some food on the table. You know that this “loan” is actually giving the money away, as you have honored such requests in the past without ever having any of the money repaid. Should you provide the money, would you be acting as a sympathetic friend or an enabler? What factors would influence your answer, and who controls them? Where does normal caring end and “enabling” begin?
Essay 3

This essay will require you to explore the role of culture in assessment and treatment. Create a hypothetical case by identifying an individual’s culture (military, female, African American, college student, New Yorker, etc), and a substance abuse problem (alcohol, cocaine, methamphetamines, opioids, etc). Then describe a specific treatment strategy that would be sensitive to the person’s culture and addiction. Think about how the person self-identifies with the culture, cultural explanation of the illness, cultural practices re: the substance, and treatment barriers. Carefully consider how a treatment plan might look different for an American Indian with an alcohol addiction vs. a homeless person with a meth addiction, for example.

Requirements: 6 pages of text, using a minimum of 5 peer-review scholarly resources identified on a reference page in APA style. This assignment is worth 90 points. See the Content area of the course for additional information.

Readings
  • Doweiko: chapter 24
  • Lecture: Challenges of Co-occurring Disorders
Discussion 11: Co-occurring Disorders
Imagine you are a counselor in a mental health agency. Your client presents with anxiety and reveals she uses alcohol to quell her anxiety. She seems to meet the criteria for addiction. However, she does not want to talk about her use of alcohol and is not interested in stopping her use. What would you do? Would you follow her wishes and not bring it up again? Would you refuse to meet with her again until she sees an addiction professional? What are the ethical considerations here? What does the professional literature say about this dilemma? Include sources with your answer.
Discussion 12: Prevention
What do you think is the best prevention strategy: consequences (such as jail and fines), information (such as commercials, websites, seminars, etc), raising children to have a positive self-image, or something else? Explain your answer with research from professional literature and provide a reference or link to it.
Essay 4

As you may know, heroin is making a comeback in communities around the country. Let’s imagine it has not yet appeared in your community. You are on a task force charged with developing a prevention program regarding heroin. What would your program look like? Access Internet resources you have already learned about in the class and other resources you find to outline a prevention plan. Using APA style, reference the resources with your plan.

Requirements: minimum of 4 pages of text and one reference page with a minimum of 3 references, APA style. The essay is worth 50 points. See the Content area of the course for additional information.

Course Evaluation
Please evaluate the course. You will have an opportunity to evaluate the course near the end of the session. A link sent to your CougarMail will allow you to access the evaluation. Please note that these evaluations are provided so that I can improve the course, find out what students perceive to be its strengths and weaknesses, and in general assess the success of the course. Please do take the time to fill this out.
Readings
  • Doweiko:  chapters 18, 19, 20, 21, and 36
  • Lecture: Synthetic Drug Issues
Discussion 13: Gender Specific Rehab
Your text notes that only 40% of substance abuse rehabilitation programs offer gender-specific treatment. What should be included in a “gender specific” rehabilitation program? Why those components and not others? If a hypothetical woman is admitted to a male-dominated rehabilitation program and is handed a booklet on recovery for women, does that make the program “gender specific”? Does “gender specific” mean only specifically for women, or are there “gender specific” programs for men as well? Should such programs be offered? Why, or why not?
Discussion 14: Cross-Cultural Diagnosis
Can diagnostic standards created within one culture be exported to others? Give an example of when this cross-cultural diagnosis works and when it may be problematic. What types of conditions fall into either category? You can refer to the chapters assigned this week to answer the question.
Readings
  • Doweiko: chapters 32, 33, 34, and 35
  • Lecture: Mutual Support Groups and Peer Programs
Discussion 15: Medication-Assisted Treatment
Are treatments using the pharmaceutical agents an improvement over the damage that the drugs of abuse cause to the brain? Why or why not? Be specific in your answer, offering information about specific medications and specific addictions. Please cite your sources.
Discussion 16: Relapse
Relapse often happens in addiction treatment. Is relapse evidence of the failure of treatment or evidence of addiction? Should the counselor change the treatment methods if relapse happens? Why or why not? Consult the professional literature and your textbook to form your opinion. Cite your sources.
Final Exam
The Final Exam covers materials studied during weeks 5 through 8. It has 50 objective questions and you have 1 attempt to take it. The exam is timed at 60 minutes.  The exam must be completed by 11:59 pm Saturday, the last day of the course.

  Course Policies

Student Conduct

All Columbia College students, whether enrolled in a land-based or online course, are responsible for behaving in a manner consistent with Columbia College's Student Conduct Code and Acceptable Use Policy. Students violating these policies will be referred to the office of Student Affairs and/or the office of Academic Affairs for possible disciplinary action. The Student Code of Conduct and the Computer Use Policy for students can be found in the Columbia College Student Handbook. The Handbook is available online; you can also obtain a copy by calling the Student Affairs office (Campus Life) at 573-875-7400. The teacher maintains the right to manage a positive learning environment, and all students must adhere to the conventions of online etiquette.

Plagiarism

Your grade will be based in large part on the originality of your ideas and your written presentation of these ideas. Presenting the words, ideas, or expression of another in any form as your own is plagiarism. Students who fail to properly give credit for information contained in their written work (papers, journals, exams, etc.) are violating the intellectual property rights of the original author. For proper citation of the original authors, you should reference the appropriate publication manual for your degree program or course (APA, MLA, etc.). Violations are taken seriously in higher education and may result in a failing grade on the assignment, a grade of "F" for the course, or dismissal from the College.

Collaboration conducted between students without prior permission from the instructor is considered plagiarism and will be treated as such. Spouses and roommates taking the same course should be particularly careful.

All required papers may be submitted for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted papers may be included in the Turnitin.com reference database for the purpose of detecting plagiarism. This service is subject to the Terms and Conditions of Use posted on the Turnitin.com site.

Non-Discrimination

There will be no discrimination on the basis of sex, race, color, national origin, sexual orientation, religion, ideology, political affiliation, veteran status, age, physical handicap, or marital status.

Student Accessibility Resources

Students with documented disabilities who may need academic services for this course are required to register with the office of Student Accessibility Resources. Until the student has been cleared through this office, accommodations do not have to be granted. If you are a student who has a documented disability, it is important for you to read the entire syllabus as soon as possible. The structure or the content of the course may make an accommodation not feasible. Student Accessibility Resources is located in Student Affairs in AHSC 215 and can be reached by phone at (573) 875-7626 or email at sar@ccis.edu.

Online Participation

You are expected to read the assigned texts and participate in the discussions and other course activities each week. Assignments should be posted by the due dates stated on the grading schedule in your syllabus. If an emergency arises that prevents you from participating in class, please let your instructor know as soon as possible.

Attendance Policy

Attendance for a week will be counted as having submitted any assigned activity for which points are earned. Attendance for the week is based upon the date work is submitted. A class week is defined as the period of time between Monday and Sunday (except for week 8, when the work and the course will end on Saturday at midnight.) The course and system deadlines are based on the Central Time Zone.

Cougar Email

All students are provided a CougarMail account when they enroll in classes at Columbia College. You are responsible for monitoring email from that account for important messages from the College and from your instructor. You may forward your Cougar email account to another account; however, the College cannot be held responsible for breaches in security or service interruptions with other email providers.

Students should use email for private messages to the instructor and other students. The class discussions are for public messages so the class members can each see what others have to say about any given topic and respond.

Late Assignment Policy

An online class requires regular participation and a commitment to your instructor and your classmates to regularly engage in the reading, discussion and writing assignments. Although most of the online communication for this course is asynchronous, you must be able to commit to the schedule of work for the class for the next eight weeks. You must keep up with the schedule of reading and writing to successfully complete the class.

No late discussion posts will be accepted.  However, late initial posts are accepted with a penalty, provided they are submitted before the end of the week deadline.

No late essays or exams are accepted.

Course Evaluation

You will have an opportunity to evaluate the course near the end of the session. A link will be sent to your CougarMail that will allow you to access the evaluation. Be assured that the evaluations are anonymous and that your instructor will not be able to see them until after final grades are submitted.