Parental Substance Abuse And Safeguarding Children Social Work Essay

Parental Substance Abuse And Safeguarding Children Social Work Essay Substance misuse causes considerable harm and is presently an immense global issue of public concern. It is a wide-ranging problem, damaging individuals, families and entire communities. In general, substance misuse is not only growing considerably within the United Kingdom, but also worldwide. Simultaneously, the number of children involved in the vicious circle of drug taking and problem drinking by their parents is also increasing. Although governments, policy makers and practitioners are recognizing the problem and taking steps towards tackling the effects of substance abuse within families; the issue in general seems far from being solved. Alcohol is legally available and easily accessible throughout England. It is positively associated with socialising, relaxing and celebrating. Although problems linked to excessive alcohol consumption are widespread and well established, it seems that alcohol misuse is somehow more socially accepted and does not have the same stigma as using drugs. Consequently, the issue of alcohol abuse, especially in families with children, often remains undiscovered, and the negative impact and effects of the excessive drinking behaviour of parents on children remain under-recognized and neglected. Estimates by the Prime Ministers Strategy Unit (2004) are that between 780,000 and 1,3 million children in England are (in)directly affected by an alcohol problem of at least one parent in other words: 1 in 11 children live in a household where alcohol misuse is present. While alcohol and the negative consequences associated with its uncontrolled use have been around and well documented for centuries, the drug industry has only been developing and growing rapidly over the last few years. Concordant with the Advisory Council on the Misuse of Drugs (2003) up to 300,000 children or 3% of all children under 16 currently belong to a family where one or two of their parents struggle with a dangerous drug issue. Parental substance misuse is also not unheard of in social services caseloads with one quarter to one third of families known to social services as being involved with misusing drugs or alcohol (Cleaver et al., 1999; Kearney et al., 2003). Many of these children do at least temporarily not live with their addicted parents. Putting these figures together, more than 10% of all children in England are exposed to suffer under the effects of their parental drug or alcohol misuse and it is extremely likely that these numbers will continue to grow over the following years. It seems also reasonable to believe that the official figures of affected children may be under-estimating the true scale of the problem as it is extremely difficult to calculate how many families have to cope with some form or the other of substance abuse (Templeton, 2006). First, not all drug and alcohol services take proper care to establish whether or not their clients are also parents and second, not all clients are willing to provide information about the existence of own children. Third, some institutions do not disclose figures, collect data properly or tend to under-report; and fourth, nobody knows how many substance misuser are not seeking treatment and, therefore do not appear on any official statistics (Keen et al., 2001; ACMD, 2003). Consequently, missing data and a clear underestimate of the total number of affected children by parental substance misuse seem obvious. Substance abuse can include negative physical (such as health risks and neglect), psychological (such as attachment disorders and depression) as well as social (such as poverty and crime) influences on both parents and their children (Kroll et al., 2000). Parental alcohol and drug abuse can affect childrens health and development in the long term from as early as conception and often into adulthood, leading to varying forms of strong, adverse and complex consequences (Turning Point, 2006). Additionally, all conceivable types of child maltreatment have repeatedly been associated and clarified in various studies with parental substance abuse including negligence (as the most common type of abuse), sexual, emotional and physical abuse (Cleaver et al., 1999; Alison, 2000; Forrester et al., 2006). The impact of alcohol and/or drugs may also significantly affect the parents capacity of adequate parenting (Alison, 2000). The negative impact of a dependency on the substance misuser himself can lead to chaotic lifestyles, complicating and preventing parents to support and care for their own children, meeting their basic needs and providing a safe and encouraging home environment (Keen et al., 2001; Home Office, 2008). With the knowledge that parental misuse of certain substances can have a seriously negative impact on childrens physical, psychological and emotional health and development, it is essential that these children potentially at risk are identified as early as possible in order to arrange for appropriate protection and safeguard their welfare (Nottingham City, 2004). This is the responsibility of all professionals in different ranges of services; they all must be able to identify and treat substance misuse related problems by adults, and also focus on the problems of affected children (Keen and Alison, 2001). Therefore, increasingly more research is being done, policy initiatives started and family-supporting services and projects have developed rapidly (Templeton et al., 2006). Although considerable progress has been made in recognizing and tackling the problem of substance abuse and the issue has won much public awareness in the last years, sadly, the death of children through the hand s of their parents recalls that the system still fails to safeguard children at risk. Professionals face a variety of often complex issues and struggle with working unimpeded. The most common problems are a lack of understanding, gaining access to the substance misuser and their children, resilience, dilemmas about confidentiality and information sharing, inter-agency tensions, assessment, lack of training and the ability to focus on both, adults and childrens needs (Kroll and Taylor, 2000; Taylor and Kroll, 2004). Without a doubt, changes and new approaches are needed, and through joint assessment, better information sharing and inter-agency cooperation, the focus should be on effective intervention and treatment for the substance misuser as well as of the so far often invisible and neglected children (Kroll and Talyor, 2000; Head of Safeguarding Children, 2008). The first section of this essay describes effects and causes associated with parental substance abuse. It highlights the impact of drug and alcohol misuse on the foetus during pregnancy and later on the child from newborn to adulthood, as well as resilience and protective factors for affected children. Part two focuses on professionals: their responsibilities regarding childrens safeguarding and the challenges they face when confronted with substance misuse. The third section covers the legal framework of safeguarding children and other related political measures. The fourth section examines the progress made so far by looking at different projects, interventions implemented and recent developments. In contrast, section five gives an insight into reality, pointing out some of the most obvious problems and recent incidents. It touches thoroughly discussed issues such as information sharing, inter-agency cooperation and training. The last section considers aims and goals, their impleme ntation and suggests recommendations for a more effective strategy in the future. Throughout this article substance misuse/abuse refers to the use either dependant use or associated with adverse effects of prescribed (such as tranquilizers, sleeping pills, pain-killers, depressants) and illicit (such as opioids, cocaine, ecstasy, cannabis) drugs as well as alcohol (Newcastle Child Protection, 2002) with critical social, interpersonal, financial, physical and psychological negative effects for both the users and those around them (ACMD, 2003). 78 SUBSTANCE MISUSE AND EFFECTS ON PARENTS AND THEIR CHILDREN There is reasonable basis in research to suggest that a child whose parent is misusing substances is at increased risk. Substance misuse can demand a significant proportion of a parents time, money and energy, which will unavoidably reduce resources available to the child. Substance misuse may also put the child at an increased risk of neglect and emotional, physical or sexual abuse, either by the parent or because the child becomes more vulnerable to abuse by others (Lewis, 1997) Parental substance abuse does not necessarily mean that children are at risk of harm or in need or receive poor parenting in some cases they would not even be affected in a negative way (Newcastle Child Protection, 2002). However, only a few children will not have to deal with multiple, mounting and varying negative consequences and survive such a complex issue entirely unscathed. While a concrete pattern of effects can never be clearly determined due to the complexity of the issue, many of the children may be permanently affected in an adverse manner, either emotionally, physically, socially, intellectually or developmentally (ACPC, 2004). Problems include a variety of health and developmental issues, ineffective parenting, criminal activity, poverty, chaotic lifestyles and educational attainment, and have long been underestimated and an abandoned research field (Keen and Alison, 2001; HM Government, 2008). The Children Act (1989, s17 (10)) defines a child in need as unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by a local authority; his health or development is likely to be significantly impaired, or further impaired, without the provision for him of such services; or he is disabled. In this context harm means ill-treatment (sexual abuse and forms of ill-treatment which are not physical) or impairment of health (physical or mental health) or development (physical, intellectual, emotional, social or behavioural development) (The Children Act 1989, s31 (9)). Among hundreds of other prescribable substances, alcohol and opiates should be reduced or avoided at all during pregnancy. Although it is not possible to evaluate all the effects of drugs and alcohol to a full extend on a fetus, it is known that it can be damaging at any time during pregnancy (from conception onwards up to birth, with the first 3 months being particularly vulnerable), causing a variety of health and development problems. Babies whose mothers were dependant on opiates or alcohol during their pregnancy are more likely to be smaller, of lower birth weight, premature and at higher risk of the sudden infant death (ACMD, 2003). Additionally the addicted mothers affected health and her possibly poor nutrition (high levels of sugar, not enough calcium, proteins, fruits and vegetables) often have an additional negative impact on the fetus physical and psychical development and the babys health. If an unborn is exposed to maternal alcohol abuse, this cannot only lead to the familiar serious impairments related to substance abuse mentioned before, but also to a remarkably common developmental problem known as Foetal Alcohol Syndrome. Foetal Alcohol Syndrome includes a series of potential effects on children such as learning disabilities, heart defects, lower body weight, decreased height, facial deformities, vision and hearing difficulties, ADD (Attention Deficit Disorder), ADHD (Attention Deficit Disorder with Hyperactivity), conduct disorder and inappropriate behaviour (Dore et al., 1995). Expecting women sharing injection equipment or working as prostitutes to finance their drug use, live with the constant threat of being infected with HIV or hepatitis B; for children born to drug dependent mothers who are infected with HIV, hepatitis C or hepatitis B, there is also a remarkably elevated risk to be also infected during pregnancy, birth or while being breastfed (ACMD, 2003). Heavy and prolonged maternal substance abuse, both opiates and alcohol, will very likely expose the child to the Neonatal Abstinence Syndrome, which is a term for a range of problems a newborn may encounter when withdrawing from exposure to narcotics. Typical symptoms include high-pitched and excessively long periods of crying, shivering, sneezing, sweating and temperature, vomiting and diarrhea, feeding difficulties, disturbed sleeping patterns, convulsions,, irritability and hyperactivity, high sensitivity to touch, wild sucking, rapid breathing and cardiac action (Marcory and Harbin, 2000). Despite the chance that appropriate antenatal care from the beginning would increase the possibility of a healthy and normal pregnancy and satisfactory development of the fetus, mothers involved with substance dependence often do not seek antenatal care, particularly due to their fear of being stigmatized. (Newcastle Child Protection, 2002). As a baby grows older, the likelihood of experiencing some negative consequences due to its parents substance abuse is not diminished in any way and the impact will vary considerably, depending on several factors such as the childs age and stage of development. The establishment of a decent, confident and secure relationship to at least one caregiver in the early months has widely been recognized as the foundation of a childs normal development. However, children of substance misusing parents often experience parental unavailability, inconsistent care and conflictual relationships (ACMD, 2003). A habit often lets a parent focus more on acquiring and using his drugs or alcohol rather than its childrens needs. Intoxication and coping with withdrawals symptoms lead to limited time, attention and emotional unavailability (Kroll and Taylor, 2000). Further, children of drug and alcohol abusers often have to experience an enforced temporary or permanent separation or loss of a parent due to abandonment, hospitalization, imprisonment, treatment, removal or other emergencies (ACMD, 2003). All these points contribute to life-long complicated and insecure attachment. The above-specified problems commonly also affect the nature and quality of parenting, which in turn often naturally results in further difficulties in a childs development (ACMD, 2003). Research proves that many substance abusing parents lack exemplary models for parenting as they have received poor parenting and maltreatment themselves (Keen and Alison, 2001). As dependence on a substance becomes central, parents are more likely to neglect their children which bears various risks and dangers them, regardless of their age group. Children may be inadequately supervised or left alone at home, exposed to preventable accidents and/or injuries (Kroll and Taylor, 2000). But not only children are at risk of accidents, also drugged or drunken adults are exposed to a higher level of self-induced incidents such as falls, forgetting food on the hob or falling asleep with still glowing cigarettes. Parents with an addiction repeatedly also tend to be unable to fulfill their childrens own basic needs so daily hygiene, a balanced diet and general health may suffer as well as stability, routines (such as bedtimes, getting up and out for school) and boundaries (Alison, 2000). Further health risks may be provoked not taking childrens routine health appointments or problems seriously enough or careless disposal and therefore easy access to drugs, bottles, syringes and needles (Kroll and Taylor, 2000; Alison, 2000). There is also notable danger for children that have observed their parents using substances, copying them (ACMD, 2003). Girl, 2, dies drinking her mothers methadone (2002) Boy, 2, died after taking parents methadone (2006) Boy, 14, dies after drinking methadone at his aunts flat (2008) Another consequence of parental unavailability is that children are often left alone with daily adult/parental responsibilities such as caring for their younger siblings, meeting their parents needs, managing finances and household chores (Kroll, 2004). Such additional and inadequate responsibilities may in turn result in the loss of social opportunities and poor academic performance of child- some research gives evidence that children miss school (regularly) by being kept at home due to caring responsibilities and left with little time to socialize. Social isolation becomes more severe as the child grows older and starts to be careful about exposing family life to outsiders and lives in a circle of denial and secrecy due to shame and fear (ACMD, 2003). Misusing drugs or alcohol does not only contribute to negligence but often goes hand and hand with other forms of child abuse and violence at home. The possibility of abuse and child maltreatment is enforced by the likelihood that children may be exposed to a number of possible dangerous strangers or inappropriate carers within their own home (Newcastle Child Protection, 2002). Research also reveals a lower tolerance level and moderate loss of temper associated with substance abuse, causing aggressive behaviour and resulting in violence to appear frequently (Kroll, 2004). Emotional neglect and abuse is also an issue within a parental substance misusing environment. Children often either feel rejected and unloved by their parents as they concentrate and spend considerably more time on their destructive habit than with them, or embarrassed and often also guilty (Kroll, 2004). Maintaining an addiction is a financial burden, not only making it difficult to complete household costs, but also regularly leading to criminal activity to buy drugs or alcohol. Children of addicted parents are also more likely to be exposed to early criminal conduct and/or its consequences not infrequently because they have been with a parent while they had been committing a crime (ACMD, 2003). Although parents try and tend to hide their habit from their children, children sooner or later discover it and typically have to deal with it by themselves which usually adds to a variety of already existent behavioural problems due to the mentioned consequences of parental substance abuse children tend to be more aggressive, feel upset or anxious and show anti-social behaviour (ACMD, 2003). Negative parental examples and role models such as drug taking, alcohol abuse, crime, poor living conditions and inappropriate behaviour inevitably can lead a child to view their parents actions as being normal and approved so that substance abuse and outrageous conduct by themselves becomes more likely as they enter into their teens and adulthood (ACMD, 2003). Research into child resilience has shown that key protective factors can have an enormous impact on preventing children from being damaged by parental substance misuse. The field of factors includes having a parent not misusing substances, a strong bond with a caring adult and support from extended family (Templeton and Velleman, 2007). Further to mention are a violence-free home, sufficient financial resources and an upstanding support system as well as educational success and involvement in different activities (19?). Working towards personal goals and dreams, taking education or career opportunities or even leaving the parental home are also common strategies to deal with experiencing substance abuse at home (Templeton and Velleman, 2007). Parents generally are aware of the negative consequences and influence on their children, and they often experience a range of impacts as a result of their weakness which moreover will have follow-on affects for their children, for example in their parenting capacity. Many of them have experienced difficult childhoods and were poorly parented themselves in this cases drugs or alcohol are often used to deal with a range of traumas and tension associated (Alison, 2000). PROFESSIONALS It is the reliability and function of all genres of professionals and agencies including general practitioners, health visitors, doctors, midwifes, pediatricians, mental health services, family support services, treatment institutions, social services, police, educational settings and voluntary sectors to safeguard and protect children. Safeguarding is equal to keep children safe from harm and abuse both deliberate abuse as well as accidents, bullying and crime and to promote their well-being and development in a healthy and safe environment (HM Government, 2006). Everyone having contact with children must be aware that it is not acceptable to remain sidelined if a child is in need or risk of harm (Lord Laming, 2003). However, it is noteworthy that each professional recognizes and accepts the limitations of his own roles and values the essential share of others (Keen and Alison, 2001) otherwise everyones duty and the mission to put a childs welfare first soon gets lost and remai ns no ones responsibility (Inter-Agency Guidelines, (2008). Challenges When encountering parental substance abuse, all professionals face a series of dilemmas, conflicts and tensions in their work with children and adults. They often simply feel unprepared and lack the expertise, skills and training to focus and work effectively with adults and children to the same purpose, and even if they do have the proper training, professionals often just do not see their role in engaging with children or substance misusing parents (Templeton and Velleman, 2007). Professionals interviewed by Taylor and Kroll (2004) stated one after another that they lack training which covers child safeguarding and protection processes and feel inexperienced to work with children of drug and alcohol users, children in need or risk of harm. Additionally, there seems to be a common confusion among different agencies regarding their individual roles and therefore allocation of clear responsibilities. A large part of these issues lay in the individual and independent development of sub stance misuse services and child welfare approaches over the last years. While adult treatment services place the substance abusers first and often do not involve existing children, the primary purpose of child protection agencies are solely the children, generally not taking into account parents needs (Colby and Murrell, 1998 in Taylor and Kroll, 2004). But agencies working with children must also take into account the situation and the problems of the respective parents, being aware of the impact parents behaviour have on children. At the same time, services for adults must not ignore existing children, so a great cooperation between agencies and services is needed (Templeton and Velleman, 2007). Professionals and agencies have to deal with parents who may bot be easy to engage with, who may not want to cooperate with them, are reluctant to open up, tell the truth or prepare to change (Nottingham City ACPC, 2004). Therefore it can be a challenge to obtain, establish and maintain t rusting relationships with either the parents or the effected children (Inter-Agency Guidelines, 2008). On the other hand, families with a drug and/or alcohol problem fear a range of consequences and rejection by opening themselves to professionals, which usually keeps them in a twist of silence and secrecy, thus preventing them access to support and help for themselves or their children (Nottingham City ACPC, 2004). Parents are often reluctant to approach services and seek treatment, have problems to confide in others and reveal their drug and/or alcohol problem as they particularly fear that any disclosure could lead to losing their children and that their family might be treated differently, stigmatized or denied by others (Nottingham City ACPC, 2004). Although confidentiality is a key principle for such agencies, no organization can guarantee it and in some cases, professionals have to share information, especially when a childs welfare is at risk (The Stella Project, 2002). SAFEGUARDING AND LEGAL FRAMEWORK As mentioned earlier in this article, agencies, services and professionals in touch with children or/and adults who are parents have a variety of responsibilities to safeguard children, assess their needs and promote their welfare. In the United Kingdom, considerable legislative framework exists for this purpose, with the Children Act 1989 and the United Nations Convention on the Rights of the Child as the elementary and reforming pieces of child law. In general, the Children Act (1989) focuses on improving childrens lives and demands comprehensive services to all children as well as tailored ones for those with additional needs. It also clarifies that if a local authority has reasonable cause to suspect that a child who lives, or is found, in their area is suffering, or is likely to suffer, significant harm, the authority shall make, or cause to be made, such enquiries as they consider necessary to enable them to decide whether they should take any action to safeguard or promote tha t childs welfare (The Children Act 1989, s47 (1)). The Children Act also provides the legal grounds for the five Every Child Matters (2003) outcomes in law be healthy, stay safe, enjoy and achieve, make a positive contribution, achieve economic well-being. Later the Children Act (2004) implemented a requirement for local authorities and a range of agencies engaging with substance abusing parents to rank first the welfare and safety of their children. Local authorities and agencies are made responsible to determine if a child is in need and/or risk and then to take appropriate steps to protect him from (further) significant harm (ACMD, 2003). Further The Children Act (2004) focuses on co-operation to improve and secure the well-being of children. Early awareness and intervention is critical to reduce the numbers of child protection cases but assessment is an immensely complex process. When assessing the welfare of a child, practitioners must work sensitively and child-centred, analysing the parental substance misuse from the childs position to better understand the impact upon his development and life (Lord Laming, 2003). For a more standardized, coordinated, early and practical way to assess childrens individual needs, the Common Assessment Framework (CAF) was designed and forms part of the Every Child Matters (Lord Lamming, 2003). The Department of Health also provides the Framework for the Assessment of Children in Need and their Families, which is based on a more ecological approach. Further, all local authorities are required to have an Area Child Protection Committee to organize and supervise child protection measures. When determining that a child is at risk of significant harm, child protection procedures should immediately be initiated to ensure that the necessary referral is made to the social services (ACMD, 2003). It is crucial that assessment is ongoing and changes are carefully monitored when a parent is in treatment or free from drugs or alcohol dependence it does not necessarily mean that children do not longer suffer from any adverse consequences (Nottingham City ACPC, 2004). Further, if no concerns regarding the well-being of a child are established, professionals should remain in connection with the family and carefully observe them as harmless situations often quickly change into an unpredictable environment for the child (Newcastle Child Protection, 2002). PROGRESS Over the last years, there has been a wide range of Government initiatives, programmes, strategies and policies aimed at tackling (parental) substance misuse. The Updated Drug Strategy for England 2002, Models of Care for Alcohol Misusers, the Green Paper on Children at Risk, Extended Schools, the Childrens National Service Framework, Sure Start and Early Excellence Centres, mentioned above, are only some examples of key initiatives (ACMD, 2003; The Stella Project, 2002): The Updated Drug Strategy for England in general specifies a variety of actions undertaken by the Government to tackle drug use and restrict the access to Class A (heroin, cocaine) drugs. Further it acknowledges that there is not enough attention given to children of drug dependent adults and thus more focus on helping them as well as addicted mothers is needed. The Models of Care for Alcohol Misusers first effort is to identify, work towards and minimize negative consequences of alcohol abuse on children. In particular, this strategy also addresses abuse and domestic violence as the main associated problems with alcohol dependence. The Green Paper on Children at Risk is a strategy addressing a series of key recommendations of the Laming Report and aiming to implement policies to improve the life chances of children. The concept behind the Extended Schools project, initiated by the Department for Education and Skills, is that schools could create stronger relationships parents and children, motivate their pupils and so raise standards by offering a wider service such as adult education, health services and childcare. The Childrens National Service Framework main goal is to reduce inequalities in health and social services as well as upgrading the overall standard of such services. The scheme specifically concentrates on the needs of children of drug and alcohol abusers. Sure Start provides different services and support of all kind to all families in more disadvantaged areas and in cases of parental substance misuse, the Sure Start team will seek advice, refer to and work closely with the relevant practitioners and agencies. Early Excellence Centres were established to raise childrens welfare and development by working coordinated with other community agencies and offering advice, support, childcare, health services and early learning. With a comprehensive legislative framework already established in the United Kingdom and several initiatives and programmes running, it does not seem especially needed to modify existing legislations or implement new ones or start more projects to protect children effectively. Nevertheless, those already existing must be fully understood and applied by practitioners in all areas, and everyone must clearly understand his responsibilities and those of the others (Lord Lamming, 2003). However, the death of the children Baby P and Victoria Climbià ¨ are tragic examples of the failings in the child protection system. Despite considerable commitment and progress made so far, challenges remain in the protection of children and their safeguarding as well as in the daily reality of practitioners. The issues mainly surround training, adequate levels of staffing, improvement of data systems and information sharing and better coordination and cooperation problematically (Lord Lamming, 2003). REALITY The exact number of minors suffering under parental substance abuse known to social services is not clearly determined. In 1999, Cleaver et al. estimated that around 25 to 60 percent of all children in child protection proceedings were living with a parent having a drug or alcohol problem. A more recent study of 290 child custody cases in four different London boroughs revealed that 34% (100 families) where affected by substance abuse, resulting in more than 50% of all children in care proceedings and over a third of all children on the child protection files being subjects of parental substance abuse (Forrester and Harwin, 2006). Both researchers also found that most affected children were under the age of five years. Information sharing Although the government set clear guidelines on sharing information with the publication of Information sharing: Guidance for practitioners and managers in 2008, breaching confidentiality, information sharing and data protection still remain some o

Addition as Choice Essay

Substance abuse is a pervasive problem throughout the United States. It affects all populations, socioeconomic groups, ages, and races. Within the community of substance abuse treatment providers, there is an ongoing debate on whether addiction is a disease, or whether individuals who abuse substances choose to engage in the behavior. There is evidence to support both positions. This paper will examine the controversy surrounding the issue of whether addiction is a choice, and examine the arguments presented by both sides. Addiction is a Choice Many individuals view substance abuse and drug addiction as a choice. These individuals argue that addicts choose to put the addictive substance in their body, therefore triggering the subsequent chemical reaction that occurs (Schaler, 2000) Individuals who argue that addiction is a choice, do not dispute that there is a physiological reaction when the drug or alcohol enters the body, and that long-term use alters the addicts brain chemistry. What they take issue with is the disease concept of addiction. Proponents of the choice theory argue that by labeling addiction as a disease, personal responsibility is removed from the equation, thereby allowing the addict to justify continued use as they are â€Å"unable† to stop (Schaler, 2000). See more:  Social Satire in The Adventures of Huckleberry Finn Essay Experience with addiction treatment confirms the choice theory, according to proponents of this stance. The most frequently recommended and popular method of recovery from addiction is Alcoholics Anonymous and its various offshoots (Narcotics Anonymous, Cocaine Anonymous, etc.). Alcoholics Anonymous is a program that offers support to the addict and postulates that the individual must undergo a psychic and spiritual change in order to maintain abstinence and achieve physical and emotional sobriety. The 12-steps utilized by Alcoholics Anonymous primarily revolve around an individual becoming honest about their substance use, realizing the damage their use has caused to themselves and others, making amends for the damage, and developing skills to assist them in staying sober and maintaining a healthy life. Critics of the disease model argue that AA and its offshoots talk about an ethical and spiritual solution, not a medical one (Schaler, 2000). Primary treatment approaches utilized in substance abuse treatment centers revolve around a psychotherapeutic foundation, rather than a medical one. Skill building, cognitive behavioural treatment, psych educational groups, and process groups comprise the majority of treatment in drug and alcohol rehabilitation centers. These are combined with a healthy diet, treatment of any mental health issues, and plenty of exercise. Again, no evidence of treatment of any physical disease (Schaler, 2000). Perhaps individuals who are alcoholics are allergic to alcohol. They still possess choice in whether or not to take the drink, just as individuals who break out in a rash when they eat strawberries, can choose whether or not to eat a strawberry, knowing the potential consequences. Addiction as a Disease Individuals who subscribe to the addiction as disease model argue that there is a psychological as well as a physical component to addiction. Initially, the argument is made that humans are conditioned to do things that cause them pleasure. Humans will repeatedly engage in an activity that elicits a positive reward. Humans also repeatedly engage in behaviors that allow them to avoid or escape negative consequences or results. Addictive drugs have the ability to reinforce strong behavioral responses and compel conditioned memories (Young, 1999). Addictive drugs produce different effects on body systems and each has a different immediate or long-term health consequence. But what truly separates addictive drugs from other classes of drugs is their ability to alter brain chemistry involved in the processes of reinforcement, learning and memory. Addictive drugs hijack our system’s natural response to rewards (Young, 1999). Repeated drug use can significantly alter brain chemistry. Three different types of change are important for addictive drug use. Repeated use of the drug can increase tolerance, so that increasingly higher doses of the drug are required to produce the same effect. With some drugs, tolerance occurs because the drug begins to break down more efficiently, requiring more of the drug to experience the high, while in other cases, tolerance appears to occur at the level of the neurons. Another physiological change important to the development of addiction is that repeated use of some drugs can produce physical dependence, wherein the nerves in the brain and body only function normally in the presence of the drug. Failure to use the drug can result in physical withdrawal symptoms. A third way that brain chemistry is altered is in the reward pathways themselves. Repeated use of some drugs, such as methamphetamine, may cause the brain to decrease its production of dopamine and other pleasure i nducing chemicals. This can result in intense cravings when the drug is withdrawn, as the individual is unable to experience pleasure any other way (Young, 1999). One complicating variable with regard to the disease concept of addiction is that for many individuals, exposure to drugs and alcohol does not cause addiction. They are able to use opioids as prescribed and drink alcohol socially. Some individuals seem to be able to use drugs and alcohol recreationally, while others become addicted. Explanations vary. First, individuals vary in their biology, and there may be a genetic component to addiction. Second, the set of expectations associated with drug use may influence how easily one becomes addicted. Third, individuals may differ in learned vulnerability. For instance, an alcoholic, who never took pills of any kind, ceases alcohol use. After a substantial amount of time of sobriety, the alcoholic is prescribed pain medication as the result of the surgery. The alcoholic then becomes addicted to pain medication (Young, 1999). Statement of position After substantial research I am taking the position that addiction is a disease. It was initially concluded that people naturally seek out pleasurable experiences. Why else would individuals who are functional, sound decision-makers in every area of their life, be unable to control or manage their intake of alcohol or drugs, even in the face of tremendous and unpleasant consequences? Jail, loss of children, loss of jobs and homes, homelessness, engagement in criminal activities; it is hard to perceive anyone choosing to continue substance use in the face of these consequences. The chronic alcoholic or drug addict will continue use of the substance, regardless of consequences, to the point of death. This can only be the result of biochemical changes in the brain as the result of substance use, perhaps combined with a genetic predisposition to addiction. Chronic alcoholics and drug addicts should be treated with the same care that one treats a diabetic or someone with hypertension. Treatments involve behavioral changes, as well as medications, dietary changes, and exercise (McLellan, 2002). But like many with chronic disease, patients do not always cooperate with treatment. This is recognized in the medical community with regard to diabetes and hypertension, however when the alcoholic or drug addict behaves as others who have a chronic disease would, it is considered a moral issue. The argument concerning Alcoholics Anonymous and treatment centers does not hold water with regard to those with a chronic condition. Individuals enter treatment or AA programs with varying degrees of addiction. An individual may enter AA after receiving his first DUI, and decide that he has a problem and needs help to stay sober. He arrests the disease before it progresses. This is similar to the diabetic, who prior to be diagnosed with Type II diabetes, is warned by her physician that she is pre-diabetic. She proceeds to make lifestyle changes that arrest her disease, and she never becomes a full-blown diabetic. The AA program will help the addict change their lifestyle making it easier for some addicts to resist behaviors that encourage use, and eventually addiction. Multicultural Considerations Addiction is viewed differently in a variety of cultures. Within the United States, the African-American community experiences high rates of alcoholism and drug addiction. This is typically viewed as the result of genetics, combined with socioeconomic factors such as poverty, unemployment, and high educational dropout rates. The Native American community experiences rates of alcoholism much higher than any other North American culture. Hispanic culture, particularly Mexicans and Puerto Ricans show higher rates of substance use; however individuals from Cuba and Central American countries show a reduced rate of substance use (SAMHSA Office of Applied Studies, 1998). Cultural considerations need to be taken into account when providing treatment services to addicts, as different cultures view addiction differently. Some cultures, like Native American and African-American, tend to view addiction as a disease; while other cultures, like Asian or Hispanic, may view substance abuse as a mor al issue or an issue of choice. How the addict sees the disease can help determine a route of treatment. Critical Literacy The two primary positions presented in this paper regarding addiction, both attempt to determine causes of addiction. They utilize scientific methods, literature reviews, and deductive reasoning to come to their conclusions. There is a strong psychological component to addiction, combined with biochemical changes. Both views attempt to shape the existing science and research to support their positions; one from a medical framework and the other psychological/sociological framework. Civic Literacy Costs related to substance use and abuse is astronomical in the United States. The US criminalization of drugs accounts for millions of dollars spent annually on police forces, trial lawyers, judges and correctional facilities. Other financial factors to be considered are the rise in crime rates in areas where substance use is prevalent, the increase in theft and property damage; the cost in failed marriages and children neglected and abused; the cost to emergency rooms which are required to treat individuals who present in crisis, regardless of their ability to pay. Socially, substance use destroys families and undermines the values that the US was founded on.Citizens can help by educating themselves about addiction and understanding that it is a disease. The majority of addicts need treatment, jobs, housing and a variety of other services to assist them in staying clean and sober. Citizens can vote for legislation that provides funding for treatment centers and necessary social ser vices, rather than increasing the number of jails and correctional facilities. Science Literacy The medical aspects of addiction require that science be actively involved in contributing to a solution. Scientists study brain chemistry and are now able to take pictures of individual’s brains that demonstrate the dramatic changes that occur when substances are introduced to an individual’s body. Medications are being tested that may reduce the cravings that addicts experience when they withdrawal from drugs. The field of psychology contributes to the reduction of addiction by providing addicts with cognitive-behavioral restructuring with regard to substance use, and assisting with any co-occurring mental health disorders. Values Literacy Many people consider addiction a moral issue. They believe that if an individual just had enough willpower, they could choose to not use a substance they are addicted to. Many in North America believe this, and there are articles and books written regarding the topic of addiction as a choice. However, the science is clear, once a person is addicted, a variety of treatments are necessary to assist them in addressing the biochemical changes that have occurred in their body. Most of these treatments are not medical; they are psychological and involve restructuring an individual’s thought process as well as teaching them skills to cope with their addiction. Individuals with addiction should be treated as if they are a sufferer of a chronic disease, with the same level of care and compassion one would treat someone with diabetes or hypertension. Conclusion In conclusion, there exists within the United States, two views regarding addiction. Some believe that addiction is a choice and that individuals who are addicts can choose whether to use or not. Others believe in the disease model of addiction. While strong arguments are made on both sides, the science is clear with regard to the disease model, although it is likely that the truth lies somewhere in the middle.

Men and Mice

Literature Criticism Essay In essence, Of Mice and Men is a novella about dreams and aspirations. John Steinbeck sets the novel linked to the American Dream during the 1930s Great Depression, when high unemployment made plenty of poor drifters struggle in California with a naive assumption of starting a new life by owning a small piece of land. The two mostly represented characters under that background, George and Lennie, who are itinerant workers from California searching for work on ranches in Soledad, share an innocent dream of â€Å"live off the fatta the Ian† (14). Hence, dreams re integrated with hope, reality, and fate.Firstly, as a true reflection of the 1930s Great Depression in American, the story suggests that the nature of human dreams is a hope to escape from grim reality with the integral point of being independent and living happily. By creating dreams, the life is infused with a driving motive of ambition; while, without dreams and aspirations, life would lack direction and meaning, which is possible to make human sinking into despair. To George and Lennie, the dream of having a small acreage farm means Joys of self dependence, ecurity, and being their own boss, like: â€Å"we'll have a big vegetable patch and a rabbit hutch and chickens.And when it rains in the winter, we ‘II Just say the hell with goin to work, and we'll build up a fire in the stove and set around it an' listen to the rain comin' down on the roof†Nuts! † (14-15) Through the comparison to other ranch hands, George recognizes that he cannot simply accept such a meaningless life with the grind and poverty of working on ranch, as George described in the book: â€Å"Guys like us, that work on ranches, are the loneliest guys in the world. They got no family. They don ‘t belong no place†¦They ain't got nothing to look ahead to. â€Å"(13-14) This makes George believe that Lennie and him are in a unique situation, because they share a â€Å"sym biotic relationship† ( Halyersmcq) by depending each other to provide a sense of yearning for a small land to dwell in happiness, after their enduring hardship on ranch. So, this is why George claims that â€Å"With us it ain't like that. We got a future. We got somebody to talk to that gives a damn about us. † (14) Secondly, through Lennie ‘s killing of Curleys wife which eventually results in their dream lost,Steinbeck shows his audience that Just simply having and sharing a dream is not enough to bring it to reality, due to the unavoidable obstacles. Each person must be aware that obstacles against their dream tend to be difficult but not insurmountable, as long as they work hard and focus entirely on the eventual objective; otherwise, the dream would be never within reach, or even crushed by the cruel world. The intellectual handicap of Lennie limits the possibility of achieving their dream, which makes George feel that it is always hard to keep Lennie out of trouble and keep them on track for dream.As a result, Lennie's innocent preoccupation with touching soft objects becomes the undoing of their dream in the end. In the story, when Lennie strokes the hair of Curley's wife by irritating herself, he tries to make her calm with yelling that â€Å"Oh! Please don't do none of that, George gonna say I done a bad thing. He ain't gonna let me tend no rabbits. â€Å"(91), but finally Lennie unintentionally kills her of did that. George'll be mad. â€Å"(92) At this point, it is the seeming desire of Lennie to keep dream safe but actually his fixation on the hair of Curley ‘s wife that destroys heir dream eventually.Therefore, this irony also confirms the ultra negative assertion from Crooks, who is a black stable-hand in the novel, that it is as impossible for ranch hands to get as a piece of land. â€Å"l seen hundreds of men come by on the road an' that same damn thing in their heads. Hundreds of them. They come, an' they quit an' go on; an' every damn one of 'em's got a little piece of land in his head. An' never a God damn one of 'em ever gets it. Just like heaven. Ever'body wants a little piece of Ian'. I read a plenty of books out here. Nobody never gets to heaven, and nobody gets no land. It's Just in their head.The're all the time talkin' about it, but it's Jus' in their head. â€Å"(74) Thirdly, the idea that dream is to a large extent reigned over by the philosophy of fate is reinforced in the story. Steinbeck hints to the reader that â€Å"fate keeps you set where you are, and no matter what you do, fate will keep you controlled by what is available to you in your life style. â€Å"(Haylersmcq) In the story, because George and Lennie are unable to enjoy their position in the ranch all the ime, they desire to own a piece of land and start a new life; but yet fate is against them and breaks their dream, when the goal seems Just within their grasp.Then, George and Lennie are â€Å"once again stuck w here they had started, with nothing. † (Haylersmcq) Perhaps, this ending makes George to some extent perceive that their dream is bound to be a failure regardless how much effort they make, due to the uncontrolled fate. So, this is why he says softly to Candy at the end of story that â€Å"†l think I knowed from the very first. I think I knowed we'd never do her. He usta like o hear about it so much I got to thinking maybe we would. (94) However, another main character, Slim, who is known as â€Å"the prince of the ranch† (33), seems different from George and Lennie in the story, because he is not enslaved by dreams; instead, he shows his happiness and satisfaction on working as a mule skinner in the ranch. Steinbeck's depiction on Slim makes him a bit of a perfectionist with charismatic personality and excellent skills, as: â€Å"†¦ capable of driving ten, sixteen, even twenty mules with a single line to the leaders. He was capable of killing a fly on the heeler's butt with a bull whip without touching the mule.There was a gravity in his manner and a quiet so profound that all talk stopped when he spoke. His authority was so great that his word was taken on my subject, be it politics or love. This was Slim, the Jerkline skinner. † (33) It allows us to see that Slim is one of those odd and rare individuals who are able to find and accept their position in the work and life, instead of to challenge the fate, because the nature of this acceptance is a kind of inner peace which could let people have a clear vision of what they want to get (Mwestwood).To conclude, in Of Mice and Men, dreams are integrated with hope, reality, and fate. The nature of dreams is a hope but there are still obstacles to overcome in reality. In addition, dreams are controlled by the fate, which is always so irresistible and unchallenged that to accept your position in the world is more important than to have a dream. Reference List 1 . Steinbeck, John. Of Mice and Men. New York: Penguim, 1993. 2. Hylersmcq. Characters dreams for a better life within mice and men? Web. Jan 28, 2012. 3. Mwestwood. Why doesn ‘t Slim share other men ‘s dreams in Of Mice and Men?

Kill A Mockingbird By Harper Lee - 1269 Words

The novel, To Kill a Mockingbird is set in the fictional town of Maycomb, Alabama, where the fight for equality is strong. For Charles Baker â€Å"Dill† Harris, a seven year old boy, the events in this small town will change his view of the world. Although he is originally from Meridian, Mississippi, he spends his summers in Maycomb, with his Aunt Rachel. This summer is a very special one as Dill meets Scout and Jem Finch, soon finding long lasting friendship and finding another reason to want to be in Maycomb. The first thing Dill announces to the Finch family is â€Å" Hi I’m Charles Baker Harris, and I can read† (Lee 8). This is Dill showing his playful yet serious side, reason being because he just informs them that he is capable of performing easy yet tedious tasks, throughout the book. Dill is an observer much like Scout; however, he has no vested interest or innate understanding of the various folks he encounters. Dill doesn t know his biological father, just as Scout doesn t know her mother. But Dill tells enormous lies, unlikely stories just as Mayella does during Tom s trial. He often pretends to be something he isn t, just like Dolphus Raymond does when he comes into town. He risks his safety to run away to Maycomb just as Jem risks his when he goes to collect his pants from the Radleys. â€Å"Dill was a curiosity. He wore blue linen shorts that buttoned to his shirt, his hair was snow white and stuck to his head like duckfluff; he was a year my senior but I towered overShow MoreRelatedKill A Mockingbird By Harper Lee1049 Words   |  5 PagesTo Kill a Mockingbird: How a Story could be based on True Events in Everyday LifeDaisy GaskinsCoastal Pines Technical Collegeâ€Æ'Harper Lee was born in Monroeville, Alabama. Her father was a former newspaper editor and proprietor, who had served as a state senator and practiced as a lawyer in Monroeville. Also Finch was known as the maiden name of Lee’s mother. With that being said Harper Lee became a writer like her father, but she became a American writer, famous for her race relations novel â€Å"ToRead MoreTo Kill a Mockingbird by Harper Lee1000 Words   |  4 Pagesworld-wide recognition to the many faces of prejudice is an accomplishment of its own. Author Harper Lee has had the honor to accomplish just that through her novel, To Kill a Mockingbird, a moving and inspirational story about a young girl learning the difference between the good and the bad of the world. In the small town of Monroeville, Alabama, Nelle Harper Lee was born on April 28, 1926. Growing up, Harper Lee had three siblings: two sisters and an older brother. She and her siblings grew up modestlyRead MoreKill A Mockingbird By Harper Lee1290 Words   |  6 PagesHarper Lee published To Kill a Mockingbird duri ng a rough period in American history, also known as the Civil Rights Movement. This plot dives into the social issues faced by African-Americans in the south, like Tom Robinson. Lee felt that the unfair treatment towards blacks were persistent, not coming to an end any time in the foreseeable future. This dark movement drove her to publish this novel hopeful that it would encourage the society to realize that the harsh racism must stop. Lee effectivelyRead MoreKill A Mockingbird By Harper Lee873 Words   |  4 PagesIn the book, To Kill a Mockingbird, Harper Lee illustrates that â€Å"it’s a sin to kill a mockingbird† throughout the novel by writing innocent characters that have been harmed by evil. Tom Robinson’s persecution is a symbol for the death of a mockingbird. The hunters shooting the bird would in this case be the Maycomb County folk. Lee sets the time in the story in the early 1950s, when the Great Depression was going on and there was poverty every where. The mindset of people back then was that blackRead MoreKill A Mockingbird By Harper Lee963 Words   |  4 Pagesgrowing up, when older characters give advice to children or siblings.Growing up is used frequently in the novel To Kill a Mockingbird by Harper Lee. Harper Lee uses the theme growing up in To Kill a Mockingbird to change characters opinion, develop characters through their world, and utilizes prejudice to reveal growing up. One major cause growing up is used in To Kill a Mockingbird is to represent a change of opinion. One part growing up was shown in is through the trial in part two of the novelRead MoreKill A Mockingbird By Harper Lee1052 Words   |  5 PagesTo Kill a Mockingbird by Harper Lee takes place in Maycomb County, Alabama in the late 30s early 40s , after the great depression when poverty and unemployment were widespread throughout the United States. Why is the preconception of racism, discrimination, and antagonism so highly related to some of the characters in this book? People often have a preconceived idea or are biased about one’s decision to live, dress, or talk. Throughout To Kill a Mockingbird, Harper Lee examines the preconceptionRead MoreHarper Lee and to Kill a Mockingbird931 Words   |  4 PagesHarper Lee and her Works Harper Lee knew first hand about the life in the south in the 1930s. She was born in Monroeville, Alabama in 1926 (Castleman 2). Harper Lee was described by one of her friends as Queen of the Tomboys (Castleman 3). Scout Finch, the main character of Lees Novel, To Kill a Mockinbird, was also a tomboy. Many aspects of To Kill a Mockingbird are autobiographical (Castleman 3). Harper Lees parents were Amasa Coleman Lee and Frances Finch Lee. She was the youngestRead MoreKill A Mockingbird By Harper Lee1695 Words   |  7 PagesIn To Kill a Mockingbird Harper Lee presents as a ‘tired old town’ where the inhabitants have ‘nowhere to go’ it is set in the 1930s when prejudices and racism were at a peak. Lee uses Maycomb town to highlight prejudices, racism, poverty and social inequality. In chapter 2 Lee presents the town of Maycomb to be poverty stricken, emphasised through the characterisation of Walter Cunningham. When it is discovered he has no lunch on the first day of school, Scout tries to explain the situation to MissRead MoreKill A Mockingbird By Harper Lee1876 Words   |  8 PagesThough Harper Lee only published two novels, her accomplishments are abundant. Throughout her career Lee claimed: the Presidential Medal of Freedom, Pulitzer Prize for Fiction, Goodreads Choice Awards Best Fiction, and Quill Award for Audio Book. Lee was also inducted into the American Academy of Arts and Letters. This honor society is a huge accomplishment and is considered the highest recognition for artistic talent and accomplishment in the United States. Along with these accomplishments, herRead MoreKill A Mockingbird, By Harper Lee1197 Words   |  5 Pagessuch as crops, houses, and land, and money was awfully limited. These conflicts construct Harper Lee’s novel, To Kill a Mocking Bird. In To Kill a Mocking Bird, Lee establishes the concurrence of good and evil, meaning whether people are naturally good or naturally evil. Lee uses symbolism, characterization, and plot to portray the instinctive of good and evil. To Kill a Mocking Bird, a novel by Harper Lee takes place during the 1930s in the Southern United States. The protagonist, Scout Finch,