Trauma and Substance Abuse by yurtgc548


									    Karina Forrest-Perkins, MHR
Gateway to Prevention and Recovery
 Understand how the brain was     intended to develop
 Directional growth patterns
 Balance of neurotransmitters
 Survival in tandem with experience/expectant maturation – ages 0-3
 Cortisol presence, intended and unintended
 Effects of over-infusion of cortisol during threat
 Interruption and maladjustment in development – ages 0-6, and 6-12
 Differences in early childhood trauma and adult trauma
 Memory Storage maladjustments – Left and Right Brain
 Amygdala, Thalamus
 Spinal Cord/Pons/Limbic System/Frontal Cortex Development
 What happens with introduction of trauma?

    What      is trauma?
 Most would agree that trauma includes the following ingredients:
 (1) seriously threatens the health or survival of the individual;
 (2) renders the individual powerless in the face of overwhelming
  fear or arousal;
 (3) overwhelms the individual's coping capacity; and
 (4) violates basic assumptions about the environment's (human or
  physical) benevolence and safety (adapted from Eisen &
  Goodman, 1998)(Additional: DSM V planning Council, van der
  Kolk, 2005-7)
 Left and Right Brain/Corpus Callosum Membrane

   Trauma Memory Storage
   Post Trauma Incident, cortisol reduction contributing
    factor to re-enactment
   Long Term Hypervigilence – over development of
    survival mode and underdevelopment of cognitive
   Contributing factor to re-enactment. Where are the
    most advanced skills? Why drawn to high risk
    behavior? What activates skills?
 Effects of substance use and abuse on the brain –
 consider age and brain development

 Neurotransmitter imbalance

 Reward system disruption
 Over 51% of all adolescents in co-occurring
    residential settings have trauma histories resulting
    in a diagnosis of PTSD
   Over 79% of co-occurring clients nationwide have
    trauma histories they consider to be significant
   ACES Study
   NIDA
   Duke University
 We do not know   conclusively if the trauma history
 was always the pre-cursor to substance use or if
 the substance use put individuals in positions
 where trauma was likely to occur or both.
 Treatment? Do we treat one then
 another? Or Both? What is best for the
 Consider the age of the client
 Consider a trauma screen for all clients
 Things to remember in co-occurring/treatment
   NOT necessary to discuss details
   SAFE exercises for re-integrating cognitive and body
   MODALITITES that fit the individual
     Best Treatment Centers: Screen staff and
      organizations for trauma history: provide resources
      for them as well.
 American Psychiatric Association, Diagnostic and
  Statistical Manual of Mental Disorder, Revised (DSM IV-
  R) 4th ed. Washington, DC: APA, 2000).
 Lise Addario, Six Degrees from Liberation: Legal Needs
  of Women in Criminal and Other Matters (Research
  and Statistics Report) (Ottawa: Department of Justice,
 Dr. Bruce Perry and
  Please feel free to research this website and Dr. Perry’s
  online course in trauma and brain development.
   American Association of Neurological Surgeons

   Prevent Child Abuse America
    200 S. Michigan Avenue, 17th Floor
    Chicago, Illinois 60604-2404
    (800) CHILDREN
    Tel: (312) 663-3520
    Fax: (312) 939-8962

   Child Welfare League of America
    440 First Street, NW, Third Floor
    Washington, DC 20001-2085
    Tel. (202) 638-2952
    FAX (202) 638-4004

    407 South Dearborn Street Suite 1300
    Chicago, IL 60605

   The National Center for PTSD
International Society for Traumatic Stress Study (ISTSS)
The International Society for Traumatic Stress Studies (ISTSS),
  founded in 1985, provides a forum for the sharing of
  research, clinical strategies, public policy concerns and
  theoretical formulations on trauma in the United States and
  around the world. ISTSS is dedicated to the discovery and
  dissemination of knowledge and to the stimulation of policy,
  program and service initiatives that seek to reduce traumatic
  stressors and their immediate and long-term consequences.

  60 Revere Drive, Suite 500
  Northbrook, Illinois 60062 USA
  Phone: 847/480-9028; Fax: 847/480-9282
Collaborative Family Healthcare Coalition (CFHC) is a diverse group of physicians, nurses,
psychologists, social workers, family therapists and other health care workers, working in
primary and tertiary care settings, who study, implement, and advocate for the collaborative
family health care paradigm.

    40 W. 12th Street
    New York, NY 10011-8604
    (212) 675-2477

NEW - offers easy access to federal and state statistics and reports on
children and their families, including: population and family characteristics, economic
health, behavior and social environment, and education.

        John Briere
        Christine Courtois
        Peter Levine
        Sandy Bloom
        Bruce Perry
Karina Forrest-Perkins, MHR
Chief Operating Officer
Gateway to Prevention and Recovery
405-273-1170 ext 113
405-788-2208 cell

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