Substance Abuse and Addiction成瘾

• In Canada more recent numbers of the Opioid overdose deaths are tracked per province
• In 2022 Opioid overdoses were tracked per 100,000 population of each province
• A substance abuse disorder involves using substances in ways that can be harmful
• Addiction can be described as the presence of the 4Cs: Craving, Loss of Control, Compulsion to use, and Use despite Consequences
• Substance-related disorders present themselves in many ways

What substance abuse looks like:

• Inability to attend work, school, or daily activities
• May lead to physical or mental health issues
• Ongoing use despite negative effects
• Higher agitation levels
• Neglecting self-care
• Theft to support substance use
• Lying about whereabouts
• Secretiveness.
• Alcohol is the most common substance in Hamilton
• Many Hamiltonians often drink excessively
• Risk is impacted by: amount, frequency and the way you drink
• Cannabis comes from the hemp plant
• Cannabis can be smoked, vaped, or ingested
• Cannabis has over 400 chemicals
• THC is the psychoactive chemical
• THC content today is more potent than in the past
• Higher potency can result in more harmful effects

Facts on Opioids

• Hamilton Paramedic Serivces responded to nine suspected overdose incidents between January 1 and January 5, 2025

Prognosis

• Abstinence or harm-reduction are two types of treatments
• Abstinence may not be the most beneficial for every person
• The Transtheoretical Model (Stages of Change) demonstrates behavior change in treatment, relapse is a natural part
• Reviews for abstinence and harm-reduction are mixed

Harm Reduction

• "Harm reduction" refers to a strategy of helping addicts minimize safety risks rather than stop completely

Systems Affected

• A substance use disorder affects the whole body

Secondary problems

• Substance abuse almost always comes with other problems

Common Treatment and Medications

• Medication-based treatment is best used with counselling
• For quitting smoking: Patches, gum, inhalers or Bupropion (Zyban)
• For heroin or opioid dependence: Methadone or buprenorphine
• For people who want to reduce cravings for drinking, and blocking effect of opiods: Naltrexone (Revia)
• For alcohol dependence: Disulfiram (Antabuse)

Common Treatment

• Withdrawal Management
• Stress or anger management
• Grief and trauma
• Finding a job or going back to school
• Healthy eating
• Accessing safe, affordable housing
• Getting social assistance or disability benefits
• Managing money and budgeting
• Developing parenting skills

Recreation Therapy Interventions

• Improved FItness
• Enhanced coordination
• Increased strength
• Better sleep patterns
• Boosted energy levels
• TR is a support for clients to become addicted to something else on their journey, so need to be mindful if positive or negative
• Key consideration is to plan carefully for community outings
• Never make assumptions
• Support your clients
• Don't Judge Them
• All significant deficits found during the process need to be addressed
• Promote a sage environment
• Set goals
• Always have a plan in place with resources and a backup
• Plan for safety
• Be prepared to manage emotions
• What works for one individual may not work for another, so abstain from harm reduction
• Understand substance abuse with relationships in leisure programs
• Understand those that relapse can lower level of participation
• Different disorders or dependencies participate

Organizations

• Hamilton Drug Strategy: collaboration and action to shift the ways of approaching substance abuse
• Public Health Ontario provides many drug testing, labs, data, protocols and education resources
• Government of Canada Website stats and resources for types of substance use disorder
• Government of Canada Website lists services and phone numbers

Activity

• Weighing the pros and cons of each substance to discuss
• Is it agreed abuse of these substances needs addressing?
• For smart goals, are they weighing pros and cons

Key Points

• It is important to focus on redeveloping positive social skills
• Not all persons may relapse at any time
• The repsiratory system is affected by substance abuse disorder

Leisure Ability Model

• Designed to promote ones relation back to self

Relapse

• Support clients and avoid judgement

Public Health Ontario

• Provides various tools for substance use

Best Practice Research

• Leisure and recreational therapists role in aiding readjustment