External and Internal Barriers to Treatment of Substance Abuse Essay

Abstract:

The treatment of substance abusers can either be successful or a failure because of different factors surrounding the programs that have been put in place. These barriers can either be internal, that is coming from the substance abuser, or external. External barriers are the outside forces that have a hand in the efficiency of any treatment or rehabilitation program. This paper seeks to elucidate on these barriers in a more comprehensive manner.

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Alcohol and Substance Abuse is a social problem that is taking toll amongst all age groups from teenagers, young adults, mature adults and even the seniors or those in their prime ages. Abuse of these substances can be linked or associated with many factors and also has many far reaching effects including the placing of the victims at a risk of mental retardation. It has been seen to fuel many criminal activities and anti-social behaviors especially in the attempt to finance the habit. Treatment is thus very important as it can improve the addicts’ qualities of life as well as lessen the incidences of criminal activities. There are many institutions that have come up with programs that are meant to mitigate these problems through such interventions as rehabilitation. The efficiency of these programs is of utmost importance because it dictates the number of people that will benefit from them. One of the factors that can hamper the efficiency is the existence of barriers. These can either be external or internal barriers.

Barriers are any obstacles to the effective treatment of alcohol and substance abusers. Internal barriers are those that emanate from within the patient himself. They have a lot to do with their attitudes towards treatment, their beliefs and inclinations (Allen, 1995). Some people feel like they do not need the treatment for various reasons like age whereby they view themselves as too old and living in their last days such that treatment becomes an unnecessary cost. The seniors perceive the treatment process as expensive and prefer to save up for their children’s futures other than spend those funds on treatment programs. Others feel like they have controlled intake of the substance they are abusing e.g. alcohol or cocaine and consider themselves on the safe side since they feel that they are not controlled by the substance. There is also the aspect of denial where the substance abusers feel like they really don’t have a problem and that it can end with the reduction of their stressors. Internal barriers can also be manifested as fear of what entails treatment.  Previous treatment experience can make a patient to be apprehensive about attending a rehabilitation center. Usually the patients have no specific reasons for their fears but it can be noted that some are more concerned with what the significant others will think about them. Those whose thoughts matter are for instance children and other family members as well as friends. Stigma plays a big part in the decision making of patients and makes them not opt for treatment for fear of disclosure of their state of affairs. The privacy of their treatment program becomes very important and most often than not they find themselves shying away from treatment (Jessup, Humphreys, Brindis and Lee, 2003). According to Grant, 1997, internal barriers are more influential than external ones. Internal factors have been found to hamper treatment programs at a higher rate as compared to external factors.

External barriers are those factors that are from ‘without’ the person. They come about as a result of outside forces such as the financial state of individual, environmental factors as well as social and cultural factors. An example of an external barrier is the lack of finances to enter treatment programs. Such barriers are not very influential because the patient may be willing to undergo treatment but is rendered incapable because of external forces. African- Americans who abuse cocaine can be said to be among the ethnic minority in this demographic region. Most of them lack the resources to seek treatment even though they are willing to change (Grant, 1997). Some feel like the fact that they are black they may not get the treatment that is supposed to be given them. Another example of an external barrier is challenges in getting transport to and from the rehabilitation centers, a factor that can contribute to the lack of completion of treatment. Some institutions do not give comprehensive services at one site and have branches that are separated. This means that for one to be through with the treatment, he would have to travel to different places which can clearly lead to inefficiency in treatment because the client may be challenged to make all the required trips.

 There are also structural problems like insufficient competent staff such that a few professionals have to attend to a large number of clients meaning that one member of staff has to take care of many people. This means that patients cannot get quality treatment. Lack of political support is also another external barrier because this would mean that the institution will not get funding from for instance the government. Many laws and by-laws are made by politicians and without political back-up an institution can not be in a position to perform to its optimal level. In gender specific institutions such as that which has female substance abusers, the use of male-oriented treatment techniques can be one barrier to the reformation of these female clients while female-based treatment has the same if effect for male clients (Ashley, O. S., Marsden, M. E., & Brady, T. M., 2003). Lack of funds also leads to a shortage in very important facilities such as those that are specifically for childcare. Shortage of such facilities makes treatment of children impossible. They are thus left out unwillingly because the available facilities may not be very useful and effective in their treatment since they may have to use the facilities used by adults.

Barriers will remain in the treatment or rehabilitation of alcohol and substance abusers but a lot can be done especially for external barriers whereby fundraising activities can be adopted because this will lead to recruitment and thorough training of more staff as well as give solutions for other problems. Internal barriers can also be overcome through proper pre-treatment of substance abusers. Internal barriers are more intense that external barriers because the latter can be changed or rectified by external factors whereas internal barriers can only be undone by the substance abuser himself.

References:

 Allen K.(1995). Barriers to treatment for addicted African-American women. Journal of            the American Medical Association.87:751–756.

Ashley, O. S., Marsden, M. E., & Brady, T. M. (2003). Effectiveness of substance abuse treatment programming for women: A review. American Journal of Drug and          Alcohol Abuse 29(1):19-53;

Grant BF.(1997). Barriers to alcoholism treatment: Reasons for not seeking treatment in             a general population sample. Journal of Studies on Alcohol. 58:365–371.     [PubMed]

Jessup MA, Humphreys JC, Brindis CD, Lee KA.(2003). Extrinsic barriers to substance            abuse             treatment among pregnant drug dependent women. Journal of Drug Issues.          33(2):285–304.

 

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