Treatment of Substance Abuse Problems in Sport Penelope P. Ziegler, M.D. Williamsburg Place and The - PowerPoint PPT Presentation

Loading...

PPT – Treatment of Substance Abuse Problems in Sport Penelope P. Ziegler, M.D. Williamsburg Place and The PowerPoint presentation | free to download - id: ac81d-NjUwO



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Treatment of Substance Abuse Problems in Sport Penelope P. Ziegler, M.D. Williamsburg Place and The

Description:

Levels of Sport Involved. Secondary schools. College athletics. Professional sports ' ... Sports medicine doctors. Physical therapists and trainers. Coaches ... – PowerPoint PPT presentation

Number of Views:41
Avg rating:3.0/5.0
Slides: 23
Provided by: penelope8
Learn more at: http://www.vata.us
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Treatment of Substance Abuse Problems in Sport Penelope P. Ziegler, M.D. Williamsburg Place and The


1
Treatment of Substance Abuse Problems in
SportPenelope P. Ziegler, M.D.Williamsburg
Place and The William J. Farley
CenterWilliamsburg, VA
2
Substances of Concern
  • Legal substances and process addictions
  • Alcohol
  • Nicotine
  • Food
  • Gambling
  • Illicit drugs
  • Marijuana
  • Stimulants
  • Club drugs- ecstasy, GHB, ketamine, etc.
  • Heroin
  • Prescription drugs
  • Opioids
  • Sedatives
  • Stimulants- Ritalin, Adderal, etc.
  • Performance enhancing substances
  • Steroids
  • Other hormones and substances
  • Over-the-counter drugs

3
What Do They Have in Common?
  • All stimulate the midbrains reward system by
    increasing dopamine levels
  • Repeated overstimulation of this pathway in
    vulnerable individuals leads to permanent brain
    alterations addiction
  • Vulnerabilities
  • Genetic
  • Acquired

4
Genetic Vulnerabilities
  • Family history of addictive disorders
  • Alcoholism
  • Other drug addiction
  • Compulsive gambling
  • Eating disorders
  • Family history of bipolar disorder

5
Acquired Vulnerabilities
  • Exposure to drugs in utero
  • Early onset of drug use
  • Certain psychiatric disorders
  • Bipolar disorder
  • Attention deficit hyperactivity disorder
  • When untreated, greatly increases risk of
    developing addiction
  • Treatment reduces this risk
  • Post traumatic stress disorder

6
Levels of Sport Involved
  • Secondary schools
  • College athletics
  • Professional sports
  • Weekend warriors
  • Unofficial team sporting leagues and activities

7
Impact of Substance Use
  • Impaired academic function leading to
    ineligibility for sports participation
  • Impaired physical functioning leading to sports
    injuries
  • Impaired adherence and participation in rehab
    leading to delayed healing
  • Impaired function on re-entry into sport leading
    to re-injury

8
Hierarchy of Problems
  • Curiosity and experimentation
  • Regular, non-problematic social use
  • Use in violation of rules of sport or law
  • Repeated use in situations which could cause
    danger to self or others (abuse)
  • Out of control use inability to cut down or stop
    use continued use despite adverse consequences
    development of tolerance and/or withdrawal
    impairment of social and occupational function
    due to use (addiction)

9
Development of Addiction
  • In vulnerable individuals, once drug use starts,
    progressive changes in brain function and
    structure lead to changes in behavior.
  • Drug taking moves from experimentation to regular
    use to compulsive, out of control use.
  • Without help, the addicted person is unable to
    stop or control use despite increasingly severe
    negative consequences, and despite his/her
    efforts.

10
Brain Circuits Involved in Drug Addiction
PFC
INHIBITORY CONTROL
ACG
OFC
SCC
MOTIVATION/ DRIVE
REWARD
MEMORY/ LEARNING


11
Primary Treatment (Prevention)
  • Studies show that most drug prevention efforts
    have been woefully ineffective
  • Exception is focusing on impact of substance use
    on participation and performance in sport
  • At elementary school level, using coaches and
    sport stars to educate kids about risks of
    substance use
  • At secondary and collegiate level, using sports
    pros in recovery sharing their stories
  • Using sports psychologists and athletic trainers
    to identify risks and train athletes in coping
    skills needed

12
Secondary Treatment(Early Intervention)
  • Working with athletes who are experimenting with
    or abusing drugs and/or performance-enhancing
    substances but not yet addicted
  • Using specialized approaches
  • Intensive education
  • Identification of specific risk factors
  • Peer group therapy
  • Attendance at open 12-Step meetings
  • Meeting young recovering athletes

13
Tertiary Treatment(Addiction Treatment)
  • Intensive treatment at level of care appropriate
    for individuals illness
  • Treatment providers (physicians, counselors,
    rehab centers) needs to work with sports system
  • Coach
  • Athletic trainer
  • Student assistance program, player assistance
    program that oversees athletes recovery
  • Family

14
Case 1
  • 19 year old single African American sophomore
    female on basketball scholarship to large
    midwestern university
  • At risk of ineligibility due to non-attendance at
    classes and practice
  • Minor ankle sprain leads to a routine, schedule
    appointment at sports medicine outpatient clinic
  • She arrived for appointment with alcohol on her
    breath.

15
Red Flags
  • Change in behavior and performance
  • Non-attendance at classes
  • Non-attendance at practice
  • Alcohol on breath at a scheduled clinic
    appointment

16
Case 1 (continued)
  • Evaluation showed alcohol abuse and history of
    anxiety and sleep disturbance since date rape
    freshman year
  • Referred for
  • Early alcohol intervention program
  • Individual sexual trauma counseling
  • Coaching on resistance to peer pressure
  • Continued on team with understanding that further
    missed practices or alcohol use would result in
    suspension and referral to higher level of care

17
Case 2
  • 20 year old white male junior running back at Ivy
    League college had car wreck following a game
    BAC was 0.18 in E.R. Urine drug screen positive
    for cocaine and methylphenydate (Ritalin).
  • Sustained a fractured wrist and dislocated
    shoulder in wreck.
  • Seen for consultation in hospital by addiction
    specialist diagnosis middle stage addiction
    to alcohol and stimulants.

18
Special Issue Prescription Stimulants
  • High school and college athletes use prescription
    stimulants for 3 reasons
  • Performance enhancement
  • Study aids
  • Euphoria, especially when snorted
  • These drugs are readily available
  • From peers
  • From family doctor
  • From student health center

19
Case 2 (continued)
  • Referred to a residential treatment program for
    addiction that was able to incorporated intensive
    physical rehab program.
  • Assisted in connecting with a sponsor who was
    a recovering pro NFL player.
  • Able to return to school in spring semester
    and return to team for fall season with ongoing
    outpatient treatment, support and monitoring
    program.
  • Decided on career in counseling rather than pro
    ball.

20
Case 3
  • 40 year old, married Latino business owner
    admitted to an addiction rehab center for
    treatment of alcohol and opioid addiction.
  • In college, had been a star varsity soccer
    player until sustaining a knee injury rehab had
    been complicated by his drinking and unrecognized
    abuse of prescribed pain medication.
  • Never returned to the soccer team now has
    chronic pain in knee still taking opioids daily,
    and alcohol use has escalated out of control.
  • Chronic, low-level depression related to
    sedentary life style, obesity and self-hatred.

21
Missed Opportunities
  • Signs of problems following college injury
  • Drinking escalated following injury, drinking
    alone, drinking to self-medicate
  • Abuse of pain meds
  • Missing PT appointments, not showing interest in
    or motivation for rehab
  • Ways to intervene
  • Expressions of concern or caring
  • Arranging for visit by counselor or specialist
  • Dont diagnose or judge suggest assessment, help
  • Who can intervene
  • Sports medicine doctors
  • Physical therapists and trainers
  • Coaches
  • Peers

22
Case 3
  • During treatment, detoxified from alcohol and
    opioids and started on a pain management
    protocol, including PT and acupuncture.
  • Physical rehab and exercise improved physical
    conditioning, leading to weight loss and improved
    self esteem.
  • Began playing golf and swimming with peers while
    in treatment.
  • Now coaching sons soccer team and walking 5
    miles daily recently started long distance
    swimming competitions.
About PowerShow.com