A vast amount of research has indicated that in the substance abuse treatment field, like other practice disciplines, has long been characterized by incoherent idiosyncratic practices based on one’s personal practice, perception, particular styles of conversing, and/or myths (Brendel, Bennett, & Albert, 2003). Administrators within these treatment facilities have a wide array of responsibility. Administrators maintain and evaluate ongoing training and technical support for substance abuse providers. They also maintain the professional knowledge and keep abreast of changes in job related rules, statues, laws, and new business trends.
Nonetheless the gap between the treatment approaches or practices that research has shown to be efficacious and what is actually done in substance abuse treatment agencies is enormous. Research that was done by the Institute of Medicine report on “Bridging the gap between practice and research” and the National Treatment Plan was a call for connecting practice to research (Brendel, et al. ). It was estimated that nineteen percent of medical practice was based on science, but the majority was based off of opinions, “soft science”, clinical experience, or tradition (Brendel, et al. ).
Which brings one to the assumption that even less of substance abuse practice is based on science, given the state in which substance abuse practice and research is in? Today, most substance abuse treatment is administered by community-based organizations (Brendel, et al. ). Administrators of substance abuse treatment facilities have the obligation to readily incorporate recent advances in understanding the mechanisms of addiction and treatment. This gap between practice and everyday treatment represents a large portion of missed opportunity at this critical time in substance abuse treatment (Brendel, et al. ).
Drug abuse treatment has been shown to provide cost-effective benefits in terms of reduced drug use, trafficking, crime, reduced incidence of AIDS and other infectious diseases (National, 2003). Both because of these benefits and as a sample humanitarian response to a serious health problem, there is a clear rational need to provide adequate treatment for substance abusers. Issues with treatment and access to “quality of care” and “best practices” in the substance abuse sector have been a dilemma for some time now. Statistics shows that it is in ones’ best interests to provide quality care, and best practices with in our society.
The state of the economy today and substance abuse being a contributing factor creates an even more challenging quandary to deal with. Studies show that the costs to society when dealing with substance abuse, is enormous. Drug trends across the United States are indicators of the drug use, abuse, addiction, domestic violence, and child abuse (National). The National Institute on Alcohol and Alcoholism estimates that alcohol and drug abuse are associated with 100,000 deaths per year and cost society more than $100 billion per year.
For instance, in 2002 an estimated 22 million Americans suffered from substance dependence or abuse due to drugs, alcohol or both. A survey in 2002, found that 14. 6 Americans use and abuse the most commonly known illicit drug, marijuana. One third of this number; 4. 8 million, used the drug over 20 times in one month (University, 2003). Another common and highly competitive drug in the economy is tobacco. It is found that tobacco smokers make up 30 percent of the population, 12 and older.
This number is closely related to 71. 5 million or more using tobacco in the United States (U. S. today. Also in 2002, studies found that cocaine use was at its best with more that 2 million users. Of the cocaine users, 567,000 of them used crack (University). This brings us to the fact that in health care, there is no other medical condition that can be tolerated by such huge numbers unable to obtain the treatment they need. The economy and or society as a whole could not handle such an ordeal. Furthermore, to distinguish the Unites State’s (U. S. ) usage, statistics shows the levels of drugs and what drugs are being abused, representing how much of a substance abuse problem the U. S. has.
Young people from the ages 12-17 had inhalant usage higher than the use of crack cocaine. Currently illicit drug use is highest among adults’ ages 18-25 years of age. Youth between the ages of 12-17 are also contributors to about 11. 6 percent of the illicit drug use family. Knowing that our economy is recovering from hardships, 2002 studies found that 9. 5 million “full-time” workers used illicit drugs. It has also been found that 11 million people ages 12 or older, reported driving under the influence of an illicit drug during a 2002 survey (University, 2003).
The second commonly abused drug in America was that of prescription drugs (non-medical us of). There were an estimated 2. 6 percent of 6. 2 million people ages 12 or older taking prescription drugs non-medically. The abuse of prescription drugs and alcohol places a heavy burden on health resources because of the subsequent medical problems. There were 362,000, that year that recognized that they needed treatment due to their abuse of drugs and alcohol (University). Of the 362,000 needing treatment, 88,000 tried to obtain treatment for drugs, but were unable to due to the lack of access and scarce treatment.
Another 266,000 of them tried, but could not obtain treatment for alcohol abuse. In America alone, there are over 40 million adults who have both a substance use disorder and a mental illness. There is an estimate 17. 5 million adults age 18 or older with serious mental illness (University). Adults that use drugs are more likely to have a mental illness than those who don’t use drugs. Drug trends across the United States are indicators of the drug use, abuse, addiction, domestic violence, and child abuse.
The trends shown in figure 1 are the trends for seven of the most active states using and abusing drugs in the U. S. , showing the direct correlation in the amount and type of drug seized by federal authorities (University). The drug seizure gives some indication as to what type of drug is being frequently used and abused throughout the U. S. Information used in Figure 1 was obtained from the University of Florida (2003). Figure 1. Significant substance abuse levels across 7 big states, representing how much of a substance abuse problem the United States has.
With substance abuse being one of the major contributors in the economy’s demise, innovating “best practices” in treatment would benefit society and communities at large. Therefore bridging the gap between practice and research has to become less of a problem and more of the actual approach to treatment today. The gap between treatment practices and research has a lot to do with why treatment is inconsistent and ineffective. There are also policy barriers, human attitudes, stigma, suspicion, and skepticism that often hinder progress in substance addiction treatment (Brendel, et al. . The knowledge base in this field is constantly evolving and different agencies have different treatment needs.
However, there will never be one way to treat substance abuse in every given agency, but there is a framework for selecting practices or approaches that will have some degree of research evidence that will fit the need of the agency (Stevens & Morral, 2003). There is research for better practices being promoted by organizations such as the Center for Substance Abuse Prevention (CSAP), and Substance Abuse and Mental Health Services Administration (SAMSHA).
They provide insight on developments in policies, programs, and services to prevent the onset of illegal drug use, underage alcohol and tobacco use, and to reduce the negative consequences of using substances (Spotswood, 2003). Certain practices and theories that are utilized within the substance treatment facilities today are the science based prevention practices, which are another innovative form of research in healthcare (Information, 2003). This is the process in which experts’ use commonly agreed upon criteria for rating interventions.
There is a consensus that experts’ reach that tells them the evaluation research finding is credible and can be sustained. This form of practice is also known as evidence-based or research-based prevention. Evidence-based practices usually refer to programs or practices that are proven to be successful through research methodology and have produced consistently positive patterns of results (Information). These practices or model programs that have shown the greatest levels of effectiveness are those that have been established through research studies.
The development of an evidence base supported by research is necessary before conclusions can be drawn about any particular practice. Scrupulous assessment entails methodical, standardized description of a targeted population, program practices, and the theoretical relationship between clients served, practices and desired outcomes. These interventions must be shown to develop outcomes that are significant to contributors, and that are calculated without bias in research conducted by sovereign investigators (Information).
Practices with good research support will not be implemented if they do not meet practical consideration (Daley & Zuckoff, 2003). On the other hand, if too much weight is put on the practical aspects, the scientific merit may be downplayed and practices that are not the best will continue to be used, just because they are inexpensive and easy to administer. Evidence-based models will always contain enough detail so that all staff can use the practice in the same way. If this is not so, treatment manuals will not enhance fidelity and staff will be inconsistent in their practice.
Their focus is on bridging “ground-breaking” prevention to treatment providers (Daley, et al. ). Nonetheless treatment providers in the substance abuse communities have shown trends in non-effective treatment, in some instances, reasons are that of aged treatment and not implementing change (Sparks, 2003). Breaking a substance abuse cycle is a knowingly tedious process. It has been identified in today’s changing environment that health care providers in the substance abuse treatment sector make little to no change in the way treatment is conducted in their facilities.
It is duly noted in figure 2, from a National Survey on Drug Use and Health (NSDUH), how many was actually being treated for substance abuse (Substance, 2003). Treatment Received in 2002 Figure 2. This bar graph shows the need for treatment and if it was received in 2002. Therefore, in regards to the treatment of substance abuse, there need to be a progress to access and the effectiveness of treatment. Health managers in these organizations need to collaborate with the evolving innovative practices and implement where needed on a more frequent basis.
Previous strategies used have been shown to be ineffective, and are used year after year. In many communities, effective approaches go unused not because policy makers and citizens are unaware of them, but because of a lack of expertise and the organizational infrastructure to implement them (Information). As providers and researchers in this field, to overcome the problems of dissemination and application of innovative practices (best practices), is a major challenge to hurdle. In the health care field it has been identified that problems of promoting science-based practice are common (Information).
Nonetheless, there are substance abuse patients that are in need of care that will have a positive approach to their condition; which in turn will have a positive approach on society as a whole. Science-based prevention is also an approach to making change (Information). This approach is guided by several different theories of change. Science-based prevention applies evidence from rigorous evaluation research on prevention practices. It follows a process of strategic planning that focuses on the integrating thoughtful assessment, design, implementation, and evaluation into every program.
Prevention is a proactive process that empowers individuals and systems to meet the challenge of life events by creating and reinforcing conditions that promote healthy behaviors and lifestyles. These theories include: individual change theories (including theories of addiction), risk and resiliency, intra and inter organizational change theories, and community change theories (including community organizing, policy change, and public health theories) (Information). This theory is also known as the ZYX theory of successful change management (Arora, 2003).
Clients, drugs, treatment concepts are changing. Therefore, if the environment around a problem (substance abuse problem) is an ever-changing environment, then the substance abuse era has to keep abreast of those changes. Numerous challenges face all who are alcohol and drug treatment supervisors, providers, or just professionals in the substance abuse sector (Sparks). Some of these challenges may include consumer demands, and expectations, incorporating the need for standardized practices, and technological advances in treatment delivery.
These challenges will determine one’s individual ability to meet the needs of our clients and our profession’s ability to enhance the quality of care provided (Sparks). For a firm to change from a former state to the latter state critical organizational transformations have to be mastered (Sparks). Organizational means opening a new chapter in the theory of the firm. However, to keep track of a changing composition of the routines in an industry is perhaps more compelling a device for analyzing how firms and industries co-evolve than for spotting the organizational change within the individual firm.
Effective administrators understand theories of change and seek to nurture the need for change within the context of the institutional norms that defend against it (Sparks). Ultimately, leaders cultivate change as an essential means toward the achievement of institutional advancement. Individual change theory expounds on the basis that if wanting to succeed spectacularly at creating or managing change, one would have to reach the right place. This innovative theory was developed by Nigam Arora to help leaders ensure success at creating change (Arora).
This theory is believed to uncover reasons behind innovative failures. It ties together new innovations in a more comprehensive and practical framework, to successfully managing change (Arora). Theories of addiction can lead to blind alleys and bad treatments in which therapists adopt every fad and reach into a bulging bag of tricks for whatever is in hand or intuitively meets the immediate moment (Arora ). However, there have been findings of three myths about alcoholism and other addictions: nothing works, one particular approach is superior to all others, and that everything works about equally well.
There are certain things about individuals; the environment in which they live in, and about the substances involved that must be factored into theories of change. The most likely truth about addiction is that has been speculated is that it’s not a single, basic mechanism, but several problems are labeled addiction (Arora). The world of health care has seen more than its share of change in recent years, and more is still to come. Change hits each of from many directions, reflecting various roles as individuals, as caregivers for patients, and as managers of medical practices. There tends to be views of these as completely separate spheres.
But succeeding as people, caregivers, and as managers demands a common set of skills those that help manage change. Managers build an atmosphere of mutual trust and respect. As a manager in any health care setting, you can do this by treating your staff fairly and keeping them informed of events good and bad that may affect their work lives (Arora). Interacting with these entities is creating new and often dreadful challenges for health care professionals. But you can help your staff adapt to the changes that infiltrate down from them by helping to shape change from the beginning.