7665E Alcohol Use Disorder in the Correctional Setting-Part 1 Intro and Stigma

Part 1 Intro and Stigma

Pdf Summary

This document, authored by Brian Fuehrlein, MD, PhD, discusses substance use disorders (SUDs), their association with the neurobiological reward system, and the significant stigma attached to these conditions. Fuehrlein details the collective efforts of the SAMHSA-funded Opioid Response Network (ORN), which supports evidence-based prevention, harm reduction, treatment, and recovery of opioid and stimulant use disorders by providing local resources and technical assistance.<br /><br />The reward system in the brain, designed for the survival of individuals and species, reinforces behaviors such as eating, drinking, and procreation. In SUD, this system becomes "hijacked," prioritizing substance use over other activities, which disrupts the individual's executive functioning managed by the cortex. This leads to denial, broken promises, and the creation of triggers that enable the continuation of substance use.<br /><br />Several case studies are presented to highlight typical clinical presentations of patients grappling with SUDs. The document emphasizes that denial and false promises often seen in patients with SUDs are not mere lies but symptoms of the disease, contributing to broken relationships and distrust.<br /><br />Stigma surrounding SUDs is also critically addressed. This stigma can degrade and ostracize affected individuals, inhibiting their potential and happiness. The language used to describe individuals dealing with SUDs can significantly impact their treatment and societal perception, as evidenced by research showing that terms like “substance abuser” prompt recommendations for punishment, whereas "individual with a substance use disorder" tends to elicit calls for therapeutic interventions.<br /><br />The document concludes that understanding, compassion, and correct terminology are vital in treating and supporting individuals with SUDs, advocating for a lifelong commitment to comprehensive care, and the adoption of non-judgmental, motivational interviewing techniques to facilitate treatment adherence and recovery.

Keywords

substance use disorders

neurobiological reward system

stigma

Opioid Response Network

harm reduction

treatment and recovery

case studies

denial and false promises

therapeutic interventions

motivational interviewing