Social work and Drug Use

Drug misuse in Britain is a substantial and growing problem, with a significant and profound impact on the health and social functioning of many individuals. Parker et al (1995) highlight that: â€Å"Young people are increasingly using a wide range of drugs and alcohol at a younger age and the age of initiation into drug use appears to have lowered. † This assignment aims to discuss what drugs are and the individual effects and social implication of drug use. It will compare and contrast the different terms associated with drug misuse, for example recreational drug use and drug dependency. It will examine the consequences, advantages and disadvantages of decriminalisation and legalisation of drugs as well as the advantages and disadvantages of prescribing using heroin as an example. It will also look at theories surrounding substance misuse and will consider how social workers have been granted more flexibility in their intervention with substance misusers since shifting from the view that drug and alcohol misuse is a disease. In addition to this it will highlight existing debates concerning the recent and current drug policy in the UK. Service users who experience drug problems are often subject to stigmatisation, discrimination and marginalisation not only as a result of their substance use but also as a result of age, gender and poverty. However, Harbin and Murphy (2000, P. 23) highlight that: â€Å"Drug addiction can effect anyone without regard to race, class, gender or age. † This assignment will also look at what services and interventions, such as harm reduction strategies, are available to drug misusers and the accessibility of these services. The World Health Organisation (1981, P. 227) define a drug as: Any chemical entity or mixture of entities, other than those required for the maintenance of normal health (like food), the administration of which alters biological function and possibly structure. † Therefore this means that when legal drugs, such as headache tablets, or illegal drugs, such as cannabis, enter the bloodstream they can affect how a person feels. Drugs can be grouped into three main types: stimulants such as cocaine, depressants for example heroin, and hallucinogens such as magic mushrooms. (http://www. knowthescore. info, 2005). In addition to the different groupings the law divides drugs into three classes: A, B and C. Classification is based on the harm that specific drugs may cause to individuals, families and communities. (NHS Health Scotland, 2004, P. 10). Class A drugs include heroin, ecstasy and crack. In order for drugs to work, they must first enter the body. The main ways that a drug can be administered include: orally, smoking, snorting and injecting. How a person will react after taking drugs will depend on a number of factors such as the type of drug, how it is taken, what it is mixed with, the social context and whether the person is on other drugs at that time. Factors which may influence drug taking can be split into two broad categories: individual influences for example personality or genetics and environmental influences such as society, peer pressure or family. (Swadi, 1992, P. 156). All drugs affect the brain's limbic system irrespective of there legality. Different drugs act on different areas of the brain and alter the chemical balance and these changes are responsible for the feelings and sensations sometimes associated with drug use. (NHS Health Scotland, 2004, P. 7). Scientists call this the â€Å"reward† system. Usually, the limbic system responds to pleasurable experiences by releasing the neurotransmitter dopamine, which creates feelings of pleasure. This could explain why people go on to misuse drugs. However, some people can occasionally use drugs without developing a tolerance or withdrawal symptoms whereas other people abuse drugs by repeatedly using them to produce pleasure, alleviate stress, or avoid reality. This can lead to other drug related problems such as drug dependency. There are two types of dependency, psychological and physical. â€Å"Physical dependency occurs when the body is deprived of drugs†¦Ã¢â‚¬ ¦. this deprivation leads to physical symptoms that vary with the drug. † Whereas â€Å"psychological dependency †¦Ã¢â‚¬ ¦ is based more on the individual's traits (habits, lifestyle) than on the substance itself. It is the memory of the pleasure associated with the object of the dependency that the individual thinks about often and longingly. † (http://thebrain. mcgill. ca/flash. par. tml, 2002) This highlights that different drugs have different effects and will require different interventions depending on the substance being misused. Drug dependency is characterised by craving a drug so much that it has control over the person's life. For example if someone is dependent on heroin and goes without it for any length of time, they will suffer extremely unpleasant withdrawal symptoms for several days. Taking heroin will make the drug user feel ‘normal' again (Drugs Know your Stuff, 2005). In this respect the drugs are having a ‘medicinal' effect on the individual because the drug relieves the person from their withdrawal symptoms. Drug use in today's society is a problem not only for the individual but for their families and communities. Drugs: protecting families and communities (2008) supports this by saying: â€Å"The most damaging effects for communities are those caused by drug dealing, drug related crime and anti-social behaviour, which can undermine stable families and cohesive communities. † In the UK drug the social effects of addiction are most commonly associated with criminality. Drugs know your stuff (2005, P. 21) identifies that: â€Å"Every year about 40,000 people in the UK are arrested for drug offences. † An example of a drug related offence could be shoplifting. This might enable the drug user to raise money to finance their drug use. It may also be associated with the stereotypical image of young people wearing hooded tops sniffing glue or `shooting up' in shabby flats who are labelled `junkies'. However, drug use does not always fit into this image as it is not age, gender or class specific. For example, white middle class people who use cocaine as a recreational drug do not need to get involved in crime to support their drug use. Therefore drug use is not always linked to crime. This is in contrast to the view of the Governments 1998 drug strategy which had the main objective the plan to tackle drug abuse, first and foremost, as an approach of reducing crime. It focused primarily on criminality and supported drug users who had committed crimes. In addition to this, new measures were introduced under the Drugs Act (2005) where the focus is also primarily on criminality. The new Act has implemented new police powers to test for class A drugs such as heroin. These measures include â€Å"testing on arrest† which means people who are arrested for trigger offences are tested for drugs on arrest rather than when charged. The aim of this is to steer more offenders into treatment and away from crime. This will ensure that those who misuse drugs are not charged but helped to engage in treatment. However, King (2007) does not agree and believes that these measures should be discarded as they are ineffective and inefficient. As an alternative King recommends that greater use should be made of specialised drug courts. According to the recent Government drug strategy (1998) there was a particular focus on problematic drug users and links to crime because statistics showed they were responsible for 99% of the costs to society (estimated between i10 and i16 billion) 88% of which is drug related crime. (The Drugs Act, 2005) Therefore, often as an alternative to imprisonment a drug misusing offender within the criminal justice system will automatically be given priority to access treatment. Drug Treatment and Testing Orders made under Section 1A (6) of the 1991 Criminal Justice Act required offenders to attend drug treatment as a condition of a probation order. † (Hough et al, 2003, P. 6). This may cause problems because when faced with a prison sentence or a treatment programme the majority of people would most likely choose the latter even when they do not want help for their drug problems. Ironically, someone who is serious about getting help for their drug problems and has not broken the law will usually be placed on a long waiting list for treatment. Although, Tackling Drugs Changing Lives (2005) state that the average national waiting times for treatment have fallen almost three quarters since 2001; (from 9. 1 weeks in December 2001, to 2. 3 weeks in June 2007). However, this still could possibly result in non offenders slipping through the net especially since the most common referral route into treatment is self referral (NTA, 2006, P. 7). Thus possibly resulting in them not getting the treatment or support they require at that time. Therefore whilst they remain on the waiting list for treatment social workers have a responsibility to give advice on minimising harm associated with drug misuse. Government policy has prioritised criminal costs of drug use King (2007) states that the wider issues that surround drug misuse such as the effects on communities, families and health are not taken into account. Therefore advocates a harm reduction policy by saying: â€Å"Given that drugs may, and often do, cause significant harm to individuals, their family, their friends and their communities, the main aim of the law should be to reduce the amount of harm that they cause. In response to the 1998 drug strategy The Royal Society for the encouragement of Arts, Manufactures and Commerce (RSA), (2007) comment, through its Commission, that drugs are a matter of health and not just crime. The Commission argues that addiction to drugs and other substances should be treated as a chronic health condition and a social problem, not just a crime or cause of crime. In addition to this they also recommended that the primary aim of the new drugs policy should be to reduce harm. The review of the National Drug Strategy in 2008 argued that the previous drugs policy did little to help the problematic drug users and to mitigate the impact on drugs in society. Professor Anthony Kings the Chairman of the RSA Commission explains that in their view drugs in society are not just about crime. They criticised the previous strategy by saying there was too much emphasis on crime and that there needed to be a shift from crime reduction and the criminal justice system onto an understanding of the more varied and complex social problems. For example the social consequences of drug use can include social exclusion. People may lose their friends and family because of the stigma that surrounds drug misuse resulting in isolation. In addition to this drug use can have an impact on living standards and may result in homelessness for example if their drug use is given priority over their household outgoings such as rent. Therefore King (2007) suggests that there should be wraparound services which include individual social needs such as employment and housing as these problems often come hand in hand with chaotic drug use. The work of Professor A King has informed the new Government drug strategy and prior to the 2008 drug strategy being unveiled it was suggested by Prime Minister Gordon Brown that the new strategy would adopt a more holistic approach when working with drug users and there would be more support for people undergoing treatment. However, when the Government's new 2008 10-year drug strategy was revealed there were proposals to shake-up the welfare system, effectively punishing drug abusers who fail to get â€Å"clean†. The Press Association (2008) highlighted that benefit payments to drug users may be reduced if they drop out of treatment. This could possibly result in people not accessing treatment for the fear of dropping out and having their income reduced. Therefore the new strategy gives no consideration to relapse. Drug relapse is a process that begins when an individual slips back into old behaviour patterns and as identified by Regan (2003) as being the most damaging characteristic of drug taking. Relapse may occur because drug users are often stereotyped and may find it hard to reintegrate back into society. Therefore this proposal may not be very effective. In addition to this if a drug misusing parent's benefits are cut and they are faced with buying food, for their children, or drugs that they are dependent on they may not necessarily be capable of making a rational decision. Cleaver et al (1999, P. 245) lends support to this by stating: â€Å"Family income may be used to satisfy parental needs. Purchasing food and clothing or paying essential household bills may be sacrificed. † However it is recognised that parental drug use may not always affect the parent's capacity to look after their children well. The British Medical Association (1997, P. 8) highlights that: â€Å"Drug use itself by parents need not constitute a risk but neglect or abuse may be associated with problem drug use and should be addressed appropriately. † However, long term drug misuse could impact on the families' living standards and possibly result in a requirement for Social Services to intervene under section 17 of The Children Act 1989. In addition to this people may resort to crime so they can afford the drugs they are dependent on. Critics of the new drug strategy say there should be more focus on treatment and less on punishment (http://drugshealthalliance. et, 2008). Therefore better strategies need to be introduced to encourage drug users into treatment. An improvement to enable this could be not giving General Practitioners the choice to avoid providing drug treatment. This would allow people to be seen straight away by their General Practitioner and not placed on long waiting lists with other agencies. All drugs, hard or soft, illegal or legal can cause social problems to some degree. Although, it is suggested that many drugs are thought to cause problems merely because they are illegal. However, The British Medical Association (1997, P. 385) highlights that: â€Å"Both the Green and White Papers, Tackling Drugs Together, rejected any arguments for legalisation or decriminalisation on the grounds that wider use and addiction are very serious risks which no responsible Government should take on behalf of its citizens. † In contrast to this view Mullis (2003, P. 3) argues that all drug laws should be abolished. The legalisation of drugs would mean that people could buy drugs but only through legal sources, thus removing a major criminal resource and reducing crime levels. The British Medical Association (1997, P386) also suggests that crime would be significantly reduced if drugs could be purchased legally and money spent on law enforcement could be spent on treatment and education. On the other hand there is evidence that drug users commit crimes for other reasons and not just to finance their habit. Many drug users are involved in crime even when they have access to drugs on prescription such as methadone. (Graham and Bowling, 1995, P. 49). Therefore the social background of the drug user may also contribute to why they commit crimes. However, even if crime was not considerably reduced, people buying drugs through legal sources would know the strength and quality of what they were using thus possibly reducing the risk of overdose. If drugs were legalised there is no evidence to indicate that crime levels would reduce. People would still need money to purchase drugs from legal sources and as highlighted by Robertson (1998, P. 209) it is uncertain that legislation would significantly reduce the cost of drugs. In addition to this alcohol and nicotine are highly addictive drugs that hold legal status. King (2007) suggests that the Misuse of Drugs Act (1971) should be repealed and replaced with a Misuse of Substances Act which includes alcohol and tobacco. As well as being addictive they can also cause major health problems. For example smoking can cause chronic lung disease, coronary heart disease, strokes, and various cancers. â€Å"Some doctors have even reported that nicotine is just as addictive as heroin or cocaine, which indicates quite clearly as to how people become hooked so rapidly and stay hooked for so long. † http://www. helpwithsmoking. com/effects-of-nicotine. php) Heavy drinking is linked to suicide, murder, fatal accidents, and many fatal diseases. It can increase chances of developing cirrhosis of the liver, and it has been associated with many different types of cancers. However, the NHS Direct (2008) underline that drinking a moderate amount of alcohol will not do any physical or psychological harm. In a recent survey Lifeline publications (2007) highlig hted that approximately 114,000 people die every year from smoking tobacco. About 40,000 people die from using alcohol and the least amount of deaths occur as a result of all illegal drugs put together and is about 2,000 people. This clarifies that: â€Å"Although drug misuse poses risks to the user and others, from a health perspective it still remains a small problem in relation to the medical harm caused by alcohol and nicotine. † (The British Medical Association, 1997). Therefore it is evident that the reason why some drugs are illegal is nothing to do with dangerousness. If drug classification is based on the harm that specific drugs may cause to individuals, families and communities. NHS Health Scotland, 2004, P. 10) then unquestionably nicotine and alcohol would both be classified. However, consideration needs to be given when looking at the above figures because more people may use alcohol and/ or tobacco because they are socially acceptable and hold legal status. If all drugs were legal, or the same amount of people who smoked used illicit drugs, then drug related deaths may significantly increase. However King (2007) suggests that the majority of people who use drugs are able to use them without harming themselves or others. Which means, according to King, the use of illegal drugs is not always harmful anymore than alcohol use is always harmful. Although it is paramount that people are still aware of the risks involved when using legal or illegal drugs. For example high impact adverts explaining the effects on all drugs as well as warning messages on alcohol similar to the messages on cigarette packets. Although King suggests that illegal drug use is not always harmful, heroin has been ranked the most dangerous drug by researchers The Lancet (2007). These finding were based on three factors which were: physical harm; potential for dependence and the impact on society such as costs to health care. Heroin dependency is an increasing problem in the UK which causes high social and criminal costs. (Stimson, 2003, P. 1) Therefore, some view prescribing the drug as a way to reduce drug-related crime and others emphasise the advantages of heroin prescribing as a way of reducing health problems, for example blood borne viruses. However prescribing heroin may have risks as well as benefits. Prescribing might attract more people into treatment. More heroin users might get help as they would be identified thus resulting in fewer untreated heroin users in the community. In addition to this prescribing would stop or reduce illicit heroin use. This would undercut the black market in illicit heroin possibly helping to phase out drug dealers. BBC News (2002) also highlights that the idea has gained favour amongst some senior police officers, who believe it could reduce the amount of drug-related crime. However General Practitioners worry that prescribing heroin would maintain the level of dependency reducing any motivation for a person to stop using the drug creating an â€Å"addict for life. Therefore this may not necessarily be the best response to drug misuse. Since we live in a drug taking society it is paramount that there are interventions available to substance misusers to help minimise any potential harm. Under the National Occupational Standards social workers have a duty to manage risk to individuals, families, carers, groups, communities, self and colleagues. Social workers can help to reduce risks by implementing harm reduction strategies. â€Å"Harm reduction policies, programmes, services and actions work to reduce the health, social and economic harms to individuals, communities and society that are associated with the use of drugs. † (UKHRA, 2005) Harm reduction has a very high profile in drug treatment programmes it aims to focus on issues such as needle exchange schemes and the risk of infection. The strategy is led primarily through the NHS and influences the Drug Action Teams (DAT). However, the strategy mainly focuses on minimising harm associated with intravenous heroin use. The NTA (2006, P. 7) highlights that: â€Å"Heroin was identified as the main problem drug for over two thirds (67 per cent) of clients receiving drug treatment. † Nevertheless, the strategy accepts that people are drug dependent and therefore consideration is given on how best to reduce harm this includes access to information and clean injecting equipment. However, information needs to be widely available, written in relevant languages, and produced in an accessible format. Without any focus on harm reduction there are issues with blood borne viruses such as Human Immunodeficiency Virus (HIV) and Hepatitis C that could be overlooked. Hepatitis C is a viral disease that destroys liver cells and can lead to cirrhosis and liver cancer. Balkin (2004) identifies that: â€Å"Most new cases of Hepatitis C occur in people who use contaminated needles or injecting equipment for drug use. † Therefore although there are harm reduction programmes available for dug users they may not be easily accessible. For example, an intravenous heroin user who needed clean needles is not likely to travel a few miles by bus to collect them. This could result in the person using, or sharing, dirty needles which increases the risk of blood borne viruses. With this is mind it may be useful to establish if there are mobile needle exchange services available to especially in rural areas where people are often more isolated and may be less likely to travel long distances for clean needles. The advantages of this service could be that because the service comes to the people who need it, clean injecting paraphernalia is more likely to be used therefore helping to reduce the risks of blood borne viruses. However, there may be some users who might be worried about using, or not want to use, a mobile needle exchange service. This could be because of the stigma attached to drug use and they may be worried about neighbours finding out that they have a drug problem. Another service that may possibly help drug misusers to minimise harm is drug consumption rooms. However this service is currently not available in the United Kingdom. â€Å"Drug consumption rooms are places where dependent drug users are allowed to inject drugs in supervised, hygienic conditions. There are approximately 65 drug consumption rooms in operation in eight countries around the world but there are none in the UK. † (http://www. jrf. org. uk/pressroom/releases, 2006) Drug consumption rooms may help to minimise blood borne viruses and fatal overdoses. They would also help to take drug use off the streets and reduce numbers of discarded needles in public places. â€Å"Drug users who congregate in public areas or open drug scenes are often homeless and marginalised, and lack access to social and health care services. Studies suggest that severe health risks are linked to street-based injecting. † (Klee, 1995; Best et al. , 2000). Additional services within the drug consumption rooms can include needle exchange, safer injecting advice, Hepatitis B vaccines, safer sex information as well as counseling, showering and washing facilities. However, as highlighted by Drugscope (2004), there are some areas of controversy concerning drug consumption rooms. For example could the Government justify providing a service that enables people to engage legitimately in activities that are both harmful and illegal? Since drug users will take drugs regardless of there harmfulness and legality the Government should take into consideration that drug consumption rooms have potential benefits. However, if these rooms were available in the UK they might encourage people to use hard drugs or increase drug related problems in the areas where they were located. In addition to this support from communities and local services such as police would be required if the consumption rooms were to be work in communities. New or amended legislation may also be necessary since under the Misuse of Drugs Act (1971) drug possession for personal use is an offense. However if drug consumption rooms were legal then would drug possession be legal? If this was not the case then there would be a contradiction between the two. Other services available within the United Kingdom for drug misusers include voluntary agencies such as drug support agencies, counselling, rehabilitation and aftercare services. Services available need to be both accessible and available to people who require them. There are many different models that can be used when working with people with addictions. However: â€Å"When working with substance misusers it is helpful to consider two different models, the ‘disease' model and the ‘wheel of change'. † (Goodman, 2007, P. 103). In the 19th century the first disease concept was established. This model considered that alcohol and drugs were evil and people who misused them were labelled victims. Therefore, alcohol and drugs addiction was starting to be seen as a disease that required treatment. In the 20th century the second disease concept evolved and alcohol consumption was once again socially acceptable. Only a small minority of individuals developed a problem with excessive drinking. However, alcohol and drug addiction was still considered as an illness that required treatment and support. Goodman (2007) highlights that the disease model works for some and is supported in self help groups such as Alcoholics Anonymous. He goes on to explain that people accessing the programme are told that they have a disease which prevents them from controlling their drink or drug problem. Consequently they need to avoid former drinking associates or drinking situation. However this model has implications as the nature of the disease has never been identified. It also suggests that a person with drug or alcohol problems has no choice or control over their decision making thus taking away their personal responsibility. Dick (2006) lends support to this by saying: â€Å"Drug misuse is not a disease; it is a decision, like the decision to step out in front of a moving car. You would call that not a disease but an error of judgement. In addition to this by following the disease model there is no consideration given to other factors such as psychological, cultural and family factors which may influence why someone may misuse substances. Therefore it does not adopt a holistic approach when supporting the service user. However according to National Institute on Drug Abuse (2008) drug addiction is a brain disease and highlights that: â€Å"Although initial drug use might be voluntary, drugs of abuse have been shown to alter gene expression and brain circuitry, which in turn affect human behaviour. Once addiction develops, these brain changes interfere with an individual's ability to make voluntary decisions, leading to compulsive drug craving, seeking and use. † However, although this model will work for some people it may restrict social workers with their intervention because the model requires complete abstinence. Therefore there would be no harm reduction strategies needed such as needle exchange. The model also contradicts the General Social Care Council Codes of Practice (2002) as it does not work in an anti-oppressive manner. For example, by following the disease model approach the service user is not treated as an individual with individual needs and choices but as a person with no choice, control or autonomy over their situation because they are labelled as having a disease. In addition to this because the model does not adopt a holistic approach factors such as housing, employment and education are not taken into consideration. Although this model works for some consideration still needs to be given to the wider problems that surround drug misuse. The second model, the ‘wheel of change' was designed by Prochaska and Diclemente (1994). It was produced from work they had done with people wishing to change their smoking behaviour, it soon became evident that their theory was helpful for all addictive behaviours. It is a holistic approach and looks at areas such as housing and financial issues when supporting someone throughout the different stages of their alcohol or drug problems. Since the model is holistic it also allows social workers to work in partnership with other agencies such as housing. As far as social work practice is concerned this model is the value base of the codes of practice as it works within a positive framework promoting anti oppressive practice. In this model there is a cyclical process. It starts with a period of pre-contemplation when the service user does not know or feel that they have a problem. For those who are thinking about change they are at the contemplation stage. This is when the service user acknowledges the risks and problems caused by their behaviour and recognise the benefits of changing their behaviour. This may be when services are accessed, such as drug treatment agencies, for support. Following the period of contemplation service users who feel that change is desirable and possible begin preparing for the change. This stage of the cycle involves setting goals and making plans. Social workers can help service users by using motivational interviewing. This emphasises the empowerment of the service user and seeks to involve them in the work of changing their behaviour. It is non-judgmental, non-confrontational and non-adversarial. The approach attempts to increase the service users awareness of the potential problems caused, consequences experienced, and risks faced as a result of the drug taking behavior. However a great deal of commitment is required from the service user for this model to work. Once the goals have been established the changes need to be implemented. If plans are clear and goals are realistic they are more likely to be long lasting because service users may feel they can reach their aim. Strategies to deal with problematic situations that may arise, such as relapse, are also very important, as are rewards for success and ongoing support. Adapting to this new behaviour is a difficult period where huge support is required, such as positive encouragement, to enable the service user to move into a period of maintaining the change. However service users need to believe in the possibility of change otherwise this model will not work. For example, someone who had committed a crime for a drug related offence and chosen treatment over prison may not identify their drug use as a problem. Therefore this model would not work because they have not even pre contemplated change. The wheel of change model links with the social model and allows social worker more flexibility when working with service users who misuse substances because it is predominately about empowerment and it involves the service user. This approach helps people recognise the risks involved with their behaviour and allows them to do something about it. Conclusion Drug misuse in Britain is a substantial and growing problem. It is not only a problem for the individual but for the Government and society. Problems for the Government could include increased crime resulting in financial costs and overcrowded prisons. Problems for the individual include social exclusion, physical and mental health problems, finance and legal issues and relationship problems. Problems for society include increased crime and increased cost on resources for example treatment and rehabilitation, police and social service involvement. Therefore treating the individual would benefit society and the Government. Policies to help treat individuals should include wraparound services which include issues such as housing, legal and financial issues and should also offer good aftercare treatment. However the new 2008 10-year drug strategy focuses more on punishment than on treatment and does not take relapse into consideration. Therefore new strategies need to be introduced to encourage people into treatment. In addition to access to treatment should be made easier for non offenders because at present problematic drug users who commit offences get preferential treatment over those who also have problematic drug problems but have not committed any offences. Society place different values on drugs and although alcohol and nicotine are highly addictive drugs they hold legal status and are socially acceptable. However, although legalising all drugs may be unrealistic and could possibly encourage drug use it would allow drugs to be bought from legal sources. Therefore crime levels may reduce and people would know exactly what they were buying thus possibly preventing overdose. There is a large emphasis on harm reduction strategies, which mainly focus on heroin misuse, and although interventions such as needle exchange services are available for drug misusers they are not always easily accessible. Introducing drug consumption rooms to the United Kingdom has advantages as well as disadvantages. It is a controversial subject and has many contradictions regarding the law. However provided they were supervised and people used them the advantages outweigh the disadvantages. The disease model allows social workers limited flexibility when working with service users who misuse substances as it does not adopt a holistic approach. It also links with the medical model as the individual is regarded as a victim. It suggests that a person with drug or alcohol problems has no choice or control over their decision making thus taking away their personal responsibility. In addition to this it does not take into account harm reduction as the aim of the disease model is complete abstinence. Whereas the wheel of change model takes into consideration the possibility of relapse when working with drug misusers and respects the autonomy of the service user to make their own decisions. It allows social worker more flexibility because it is predominately about empowerment and it seeks to involve the service user changing their behaviour. It adopts a holistic approach when working with people with addictions of any kind and therefore social workers work in partnership with other agencies or professionals to help support the individual with additional problems that link to their substance misuse. The wheel of change model takes into account both physical and psychological factors again allowing social workers more flexibility with their intervention. Although the disease model can work for some individuals it requires limited intervention from social workers whereas the wheel of change model adopts a holistic approach which gives social workers more flexibility when working with service users who misuse substances.

Should same sex marriage be legal Essay Example | Topics and Well Written Essays - 1250 words

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Addiction is a brain disease Research Paper Example | Topics and Well Written Essays - 750 words

Addiction is a brain disease - Research Paper Example Addiction has been considered a major society’s problem and it is because of this that some experts believe it as a brain disease at some point. This paper tries to explain that addiction is indeed a disease of the brain. Addiction defined Addiction is a specific behavioral problem that is usually manifested with lack of control of using and seeking something just like drugs, sex and gambling (Gamonet & Piazza, 2010; Goodman, 2008). It is also known as a syndrome in which there is a considerable focus on the impaired control over a behavior (West & Hardy, 2006). Addiction therefore is something that takes control over someone’s life. Someone who is addicted to something else is after of uncontrolled longing for self gratification. Although addiction may differ from what a habit is, the entire point is that its manifestation can always be observed from a behavioral point of view. However, addiction can also be explained from the biological context and this primarily invo lves the study of the brain and its other related fields. Brain disease defined From a biomedical model, disease is defined based on the context of four assumptions in which one of them states that it is a deviation from normal biological functioning (Mishler, 1981). From this assumption, a brain disease therefore is implied as the brain’s inability to function well based on what a normal one can potentially do. This is a generic point of view, but the entire argument in the above assumption is that a deviation from the norm especially when there is involved biological functioning is ground to be considered as a disease. Evidences about addiction is brain disease In order to consider addiction as a brain disease, it is important to trace the very nature of a normal brain and its potential functions in the human body. The normal human brain is said to have the capacity to take control over the entire body. However, aside from the biological stand point, the brain does not only control the whole activities of the body, but primarily thoughts and behavior (Feldman, 2003). This implies that a normal brain has the capacity to create normal thoughts and behavior. Since addiction is a behavioral problem, the brain therefore has specific problem by itself considering that it should have the capacity to create normal thoughts and behaviors in the first place. Furthermore, based on the assumption about normal biological functioning of the body, a normal brain therefore has to function well as expected resulting to create normal thoughts or behaviors. Doctor Alan Lesbner, director of the National Institute of Drug Abuse personally believes that addiction is a brain disease (Walsh, 1997). This is based on the idea that drug addiction is just a result of one’s brain inability to take control of a certain behavior. Doctor Lesbner argued that not all of those who abused drugs resulted to addiction because the brain has a certain capacity to control human behavi or. In fact, not all of those who tried prohibited drugs are addicted. Furthermore, not all of those who start gambling and having sex are addicted to such of these activities. However, the abuse of drugs for instance leads to some changes in the brain and to some extent they are harmful for its normal functioning (Heyman, 2009). Some recent findings showing addiction is a brain disease supported the idea of Doctor Lesbner. Recent findings suggest that addiction is associated with dysfunction of brain tissues resulting to the disruption of regions in the brain which are capable of controlling the normal process of motivation, reward and inhibitory control (Ries et al., 2009; Heyman & Brownsberger, 2001; Flores, 1997). The advent of technological breakthroughs makes this

Analysis of the global challenges and economic situation in Argentina Essay

Analysis of the global challenges and economic situation in Argentina - Essay Example Inflation As the economic activity in Argentina has expanded in 2010, there was a sudden increase in money supply which has resulted in increasing the consumer prices. According to the Central Bank of Argentina, the YoY increase in money supply during Feb 2011 increased by nearly 27.8%. This resulted in increased inflation figures for Argentina. As a result, the exporters of the country, mainly in the manufacturing sector are losing their competitive position in the market, driven by increase in domestic costs and relative stability in the exchange rates (Ken 2011). â€Å"Beyond entrenched high inflation, the erosion of external competitiveness during 2010-2011 is another thorny issue the next administration will have to face, which, if not properly handled, could end up generating a crash- rather than soft-landing of the economy in 2012† - Alberto Ramos, Economist, Goldman Sachs, Mar 2011. As a result, Argentina’s middle class suffered most due to high inflation, there by affecting mobile phones, cable, petrol, health insurance premiums etc. in the month of Jan 2011 According to Argentina’s national statistics agency Indec, the country’s annual inflation in was 10% by the end of Feb 2011 and 10.6% by Jan 2011. Inflation was mainly supported by increase in prices of tourism services, clothing and increase in prices of food and beverages. Also, according to EIU, the inflation was supported by the government’s intervention in the agricultural sector which has resulted in the reduced production of important foodstuffs such as beef. Many local consulting companies in Argentina differ on these official inflation figures are they estimated the country’s inflation... This paper provides a thorough analysis of the recent economic developments in Argentina. The essay aims to analyse the current economic environment in Argentina, including GDP, Inflation, Industrial Production Index, agriculture, the country’s debt situation, foreign exchange rate, unemployment, Consumer ABS, Central Government revenue and expenditures. Argentina’s GDP grew by 9.2% year-on-year through the quarter ended Dec 2010. The economy’s strong performance was driven by domestic demand, with private consumption rising 11.5% year on year, up from 8.9% in the previous quarter. As the economic activity in Argentina has expanded in 2010, there was a sudden increase in money supply which has resulted in increasing the consumer prices. According to the Central Bank of Argentina, the YoY increase in money supply during Feb 2011 increased by nearly 27.8%. The country aims to impose trade barriers due to high imports. In 2010, Argentina reported 46% rise in its imports, to reach $56.4 billion. This was mainly due to heavy imports of intermediate goods used by automobile industry and capital goods industry. Argentina has stepped up trade barriers in terms of import duties or the range of products. The government should remove growth obstacles by reducing import and export tariffs and moderating its stringent price control measures. This would result in increasing the trade activity with other countries. It would also result in increasing the investors’ confidence which would result in increased FDI and FII in the country

Criminal Procedure Essay Example | Topics and Well Written Essays - 500 words

Criminal Procedure - Essay Example ith Justice Antonin Scalia, each and every constitutional law should be interpreted depending on the actual context and should not be subjected with the addition of multiple other associative meanings4;5. On the contrary, the commentators appeared to have criticized Justice Antonin Scalia stating him to be highly concentrative on the understandable meaning of the constitutional laws6. The commentators elaborated the necessity of the textualist towards understanding of the situation depending on which he /she should be interpreting the constitution laws. In accordance with the second commentator, textualisation of a constitutional law can either be projected as a narrowed down aspects or a broadened principle. Thus, the second comment implies the alignment of the commentator with the statements made by the first commentator7. The second commentator left a vagueness within the understanding of the situation as per which the narrowing or the broadening of the contextual textualisation should take place. Irrespective of all these, the third commenter presented his views upon the two types of textualists i.e. ‘semantic-originalists’ and ‘expectation-originalists’ that take specific consideration of the law writer’s intention in terms of imparting a specific meaning of the constitution that appears to be misaligned with the facts mentioned by Justice Antonin Scalia8. Justice Antonin Scalia also proved the fourth comment regarding the attainment of associated meaning from the constitutional interpretation as vague by stating that the legislation only possesses the authority of structuring the rules and it should remain confined to a specific meaning9. The alternative mentioned by Justice Antonin Scalia in terms of interpreting the constitutional laws can be considered as effective in recommending appropriate legal texts. The facts mentioned within the book has also been observed to be laying significant amount of focus on the development and introduction of a

Business Policy and Strategic Management Essay Example | Topics and Well Written Essays - 250 words - 1

Business Policy and Strategic Management - Essay Example At a time when people are struggling to pay their bills Starbuck $4 coffee appears to be a luxury in comparison to say, Dunkin’ Donuts $2 coffee. Secondly from section 1 we do not see Starbucks coming out as an organization with a strong strategy to tackle the competition that is increasing within its industry. Starbucks may be the leading coffee chain currently but the threat posed by its biggest competitors is very high. Firstly, its two main rivals are McDonalds and Dunkin’ Donuts. Within the United States, Dunkin’ Donuts is winning the battle for the no frills, cost-conscious coffee drinker and also the market segment tired of the ubiquity of Starbucks. In the global arena, McDonalds has more outlets than Starbucks and therefore poses a big threat abroad. Also we cannot fail to mention that McDonalds has $23.5 billion in revenue as compared to Starbucks’s $9.8 billion (Schwartz 1). This implies that McDonald could easily deploy more resources targete d towards pulling away consumers from Starbucks. Work cited Schwartz, Ariel. â€Å"Sustainability Faceoff: McDonald's vs. Starbucks.† Fast Company 17 May 2010. Web. 24 Mar. 2011. 

Dynamic system development methodology Essay Example for Free

Dynamic system development methodology Essay Various industries handled information and data manually until 1960 when the first software development methodology was hinted. Software development methodologies are key steps in development of information system. Different methodologies have different requirements in terms of cost, time frame, expert requirement, size of the business, maintenance cost, and flexibility in case of changes in the future among others. Therefore, organizations evaluate each methodology in order to come up with the most effect one for their information system development. Software methodology involves a structural framework to plan and manage the processes that are involved in development of information system.Prototyping and dynamic system methodology will be critically evaluated to understand the role of software methodologies in information system development. Dynamic system development methodology                   The method ensures frequent delivery of information system in businesses. The methodology is can be reversed during development in case of errors, and the requirement is based on high level and integrated testing throughout lifecycle, which allows collaboration and cooperation between all stakeholders (Association of Modern Technologies, 2014 Software Development Methodologies) Figure: 2 Baguio central University,2011. Dynamic System Development Methodology      Critical evaluation                   Since this methodology involves end users and teamwork decision, it forms the best choice for information system development. Future changes can be accommodated since changes are reversible. This methodology follows PRINCE concept since it start with initiation of a project and conclude with crossing of the project. Prototype methodology                  In this methodology, incomplete software is created, which differs with the final product (software development and engineering, 2012 n.p.). The methodology makes it possible to evaluate the software during the development process and design before it gets to the final step. The software can also be tried before integration in an organization. This method allows involvement of the users and evaluation during designing phase and thus increasing the likely hood of easier implementation in any organization. Critical evaluation                  In this methodology, users, builder and system interaction are mandatory. It requires expertise for both builders and end-users. With this model, time and cost are decreased compared to traditional method, which becomes a major consideration when developing information system. This methodology is applied mostly in situations there is risk uncertainty. This methodology is best applied in managerial systems, as its main objective is planning, direction, controlling and decision-making. This forms one of the choices for information system since users can be able to do a value analysis and investment can be made at relative increments.                Prince plays an important role in information system development since it establishes the management, control, and application of the appropriate software for information system. It gives more insight about the software developed and provides authenticity of the software, which is important in making information system decisions. Question 2 According to (Bantra et al, (2010 p 383) agile methodology is based on various values such as Individual and interaction over processes and tools, Working software under comprehensive documentation, Customer or end user collaboration over a contract negotiation the and Responding to changes over following a plan                      The agile methodology builds flexible information systems that can be upgraded or changes in future (Rao, Naidu, Chakka, 2011 p. 42). For example, if an organization wants to expand its system, it can build its new information system on the existing system. Hence, the methodology is adopted where future changes in the information system are expected. Time aspect makes this approach cost effective. The methodology involves the end users at every stage making software development process effective and accurate (Aitken Ilango 2013 4758). In addition, the process is fast and efficient thus ensuring that the information system development easy and economical.                   The traditional methodologies are fixed and do not allow future changes (Aitken Ilango 2013 p. 4756). That means that once the information system is developed using the traditional methodology, it will be hard to build a new system using it. The expansions or future changes in the information system require engineers and software developers to start a new system. This is not cost effective for business since they are always in a constant growth and keep on improving their information systems. Thus, agile methodology best suits development of a flexible information system that can be upgraded easily. Question 3                     The Structured systems analysis and design method, (SSADM) is one of the widely used methodologies in computer applications in private and public sectors since its inception in 1981. The methodology operates under three principle techniques known as logical data, flow data, and event modelling (Al-Humaidan, Rossiter, 2011, p 3).                  Logical data modelling (LDM) technique involves identification and documentation of the necessary data for business or organization information system. The information that the business wants to record on the information systems is identified and documented for inclusion in software development. Consequently, the data flow modelling (DFM) techniques involves identification, modelling and documentation of how the identified data using LDM technique will flow in the information system. It gives details on how various data will be transformed in the system. Then, event modelling (EM) technique identifies and documents the sequence of events in DFM.                     The techniques help the engineers to develop information system that meets the end users need since it allows participation of all the stakeholders. However, inadequate research may result to development of poor information systems, which may be cost to the business. The SSADM uses various tools that are important in development of information system. Data flow diagram, (DFD) highlights all the data pathways, while other tools such as data dictionary, decision trees and tables give guidelines on data classifications. The tools make operation of the information easier for the end users.                      Unified modelling language, (UML) is a language used in software engineering. It helps the developers to create a system using a standardized language that can be understood easily by both the participants and the system. The main techniques and tools used are diagram and language structures such as class, interactions and activity diagrams (Al-Humaidan, Rossiter, 2011, p 4).                      The main difference between SSADM and UML is that the former interfaces are composed of design dialogue while the latter utilises components and classes of modelled diagrams as interface (Al-Humaidan, Rossiter, 2011 p. 24-29). In addition, SSADM uses requirement catalogue as the data resources while UML uses modelled stereotype features as data sources. Question 4                     Software development approach entails identification the information system issues and making decision of how the issues should be solved and the solution remains viable. Waterfall approaches Figure1: Winston W. Royce waterfall approach and its analogous waterfall (Habib, 2013 n.p) Critical evaluation                      The approach helps to develop software in a top down development consisting of independent steps that are completed sequentially. The engineers are able to evaluate each step independent and develop consecutive phases based on completed ones. The methodology is fast and effective for development of small information systems. However, methodology is not suitable to develop large information system because it is slow and cumbersome. In addition, the approach is costly and a short term. According to Stoica et al, (2013, p. 68) this method requires product definition, clear understanding of requirements and technology, and expertise and the system is short lived. End users approach                     In this approach, the end user is the focus in the development of the information system. The information system is designed in such a way that it is able to meet the end-users needs. The approach may involve modification of commercial off-shelf software (COTs). Critical evaluation                     The approach does not involve formal designing of the information system. The approach does not require documentation of the project. The end user is the main controller of the information system developed from this approach. However, it is not fit for large business and lack of documentation limits future changes of the information system would be very hard. Thus, the approach is not economical especially of growing enterprises.                   When the size of the project is large, the software development approach is based on the cost or budget limitations, timeframe taken by the approach, and the flexibility of the approach. This is because, the organizations designs information systems that are economical in that they does not affect their profitability and operations. Approaches that are cheap and are executed in a short span of time are preferred to others that are costly and take long time before completion Reference Aitken, A., Ilango, V. 2013. A comparative analysis of traditional software engineering and agile software development. In  System Sciences (HICSS), 2013 46th Hawaii International Conference on  (pp. 4751-4760). IEEE.Al-Humaidan, F., Rossiter, B. N. 2011. A Taxonomy and Evaluation for Systems Analysis Methodologies in a Workflow Context: Structured Systems Analysis Design Method (SSADM), Unified Modelling Language (UML), Unified Process, Soft Systems Methodology (SSM) and Organisation Process Modelling (OPM).  Technical Report Series-University Of Newcastle Upon Tyne Computing Science. Baguio central University 2011.Dynamic System Development Methodology.[Online]. http://www.slideshare.net/mayjoyce89/dynamic-system-development-method. Batra, D., Weidong, X., VanderMeer, D., Dutta, K. 2010.Balancing Agile and Structured Development Approaches to Successfully Manage Large Distributed Software Projects: A Case Study from the Cruise Line Industry. Communications Of The Association For Information Systems, 27 383. Habib M, 2013. Agile software development methodologies and how to apply them. [Online] Retrieved from http://www.codeproject.com/Articles/604417/Agile-software-development-methodologies-and-how-t.accessedRao, K. N., Naidu, G. K., Chakka, P. 2011. A study of the agile software development methods, applicability and implications in industry.  International Journal of Software Engineering and its applications,  5,2, 35-45. Stoica, M., Mircea, M., Ghilic-Micu, B. 2013. Software Development: Agile vs. Traditional. InformaticaEconomica, 17,4, 64-76. Source document