Ethical issues are both personal (micro) and societal (macro). Often there is a struggle between the government’s or community’s attempt to regulate morality for the “public good” and fighting to retain an individual’s right to autonomy. It is the intense emotional nature of such concerns that takes an issue from a personal level to a societal level. Two such ethical issues related to substance use are a) communities with needle exchange programs to reduce incidence of HIV/AIDS and other blood borne disease and b) the availability of Narcan (Naloxone), which is an antidote for opioid (heroin, painkillers) overdose. What are the ethical issues involved? What is the role of a social worker? Whose best interest does the social worker serve? What are your own concerns about these issues? What does research tell us?

400 Words. APA format

Readings:

The Etiology and Epidemiology of Addiction

MODULE OVERVIEW/INTRODUCTION

Epidemiology is the study (scientific, systematic, and data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhood, school, city, state, country, global). (Source: Principles of Epidemiology (3rd ed.), Center for Disease Control).

Epidemiologic information is important in social work as it provides us with a lens to understand possible determinants of health and risk factors that may be traced to social exclusion. These studies also provide vital data to be utilized for advocacy at the community, state or national level to improve access to services, develop effective primary prevention, as well as address public policy regarding substance use disorders.

Etiology is a branch of medical science specifically concerned with the underlying cause or origin of disease. Social workers must be concerned with both the extent and risk factors of a social or medical issue as well as the underlying cause(s). Most people do not understand why or how other people become addicted to drugs and/or alcohol. It is often assumed that substance abusers lack moral principles or willpower and that they could stop using drugs simply by choosing to change their behavior. In reality, substance use disorder is a complex disease. Getting sober takes more than good intentions or a strong will. Drugs and alcohol change the brain in ways that foster compulsive substance abuse and quitting, even for those who are ready to do so, can be quite difficult. Through scientific advances, we know more about how drugs and alcohol work in the brain than ever. We also know that addiction can be successfully treated.

• Textbook: Van Wormer, K. & Davis, D.R. (2018). Chapter 3, pp. 89-149.
• Textbook: Sheff, D. (2013). Part II (Chapters 3-4).
• NIDA Material: The Science of Addiction
• Merikangas, K. R., & McClair, V. L. (2012). Epidemiology of substance use disorders. Human Genetics, 131(6), 779-789. doi:10.1007/s00439-012-1168-0
• NIDA Material: Drug Facts Nationwide trends
• Results from the Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (review the report to understand the trends, statistics and the scope of the problem in the US).
• Optional: Vaughn, M. & Perron, B. (2013). Chapters 2-3, pp. 23-46.

Multimedia

• The Neurobiology of Drug Addiction: Watch slideshow “The Reward Pathway and Addiction”
• How Addiction Hijacks the Brain: Read the article

Additional Resources

• “Prescription drug abuse and addiction kill far more people in the U.S. every year than all illegal drugs combined. The unprecedented rise in overdose deaths in the U.S. parallels a 300 percent increase since 1999 in the sale of powerful painkillers such as Vicodin and OxyContin.”
  Overdose Rates
  Prescription Opioid Overdose Data
• “Almost 70 percent of Americans take at least one prescription drug, and more than half take two, according to researchers at the Mayo Clinic and Olmsted Medical Center (source). The most commonly prescribed drugs among those studied were opioids (13 percent), antidepressants (13 percent) and antibiotics (17 percent). In 2014, almost 2 million Americans abused or were dependent on prescription opioids. As many as 1 in 4 people who receive prescription opioids long-term for noncancer pain in primary care settings struggles with addiction. Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.
  Opioid Data Analysis from CDC
  The opioid painkiller and heroin epidemic, explained (interactive, state by state data included)