Alcohol & Sub. Dep.: Family Struggling with Sobriety

Extent of the Alcohol and Drug Abuse Epidemic and its Effects on the Individual, Family and Community: Legal Aspects of Drug Abuse

What are the Punishments for Drug Crimes?
Many drug crimes are considered to be felonies. Minimum sentences for first-time drug crime offenders can range from 1 year in jail to 3 years in a prison facility. The punishments may also include fines ranging from $500 to several thousand dollars. Repeat offenders are typically sentenced for a minimum of 3-15 years in prison.

Drug laws may vary widely by state and even by local municipalities. The legal penalties for drug crimes generally depend on several factors, such as:
- The amount or quantity of the drug
- The classification of the drug according to the schedules
- The purpose of the drug possession (i.e., personal use vs. distribution)
The most serious types of drug crimes include producing, manufacturing, and/or selling illegal drugs. The intent to distribute drugs can make possession charges more serious. For example, a prosecutor can prove a defendant’s intent to distribute drugs simply by proving possession over a certain quantity of the drug. This often does not require evidence of actual distribution of the substance.

On the other hand, possession of certain drugs (such as a small amount of marijuana) can be treated like a misdemeanor or even a traffic violation in some states. These types of charges can result in probation or a fine with little to no jail time. However, possession of large amounts of drugs, even for personal consumption, can result in serious felony charges.

What are Enhanced Punishments?
Some states enforce enhanced punishments or penalties for drug crimes. A penalty enhancement may result in more severe criminal charges and penalties, for example, elevating a misdemeanor charge to a felony charge.

Enhanced criminal punishments may apply to a drug crime if:
- The drugs were distributed or sold to minors
- Minors were used to distribute the substances
- The drugs were sold or delivered near a school zone or other such protected areas
Penalty enhancements may vary by state and can include other factors besides those mentioned above. Other enhancements may include alternative sentencing measures such as rehabilitation programs or mandatory community service.

Also, persons convicted of a drug crime may be required to forfeit their property. For example, if the defendant’s house was used to manufacture or distribute the drugs, a judge may require the house to be seized.

Historical and Contemporary Perspectives on Alcohol and other Drug Abuse: Knowledge of certain Populations at Risk with Regard to Substance Abuse

Like the majority of other mental-health problems, drug abuse and addiction have no single cause. However, there are a number of biological, psychological, and social risk factors, that can increase a person's likelihood of developing a chemical-abuse or chemical-dependency disorder. The frequency to which substance-abuse disorders occur within some families seems to be higher than could be explained by an addictive environment of the family. Therefore, most substance-abuse professionals recognize a genetic aspect to the risk of drug addiction.

Psychological associations with substance abuse or addiction include mood disorders like depression, anxiety, or bipolar disorder, thought disorders like schizophrenia, as well as personality disorders like antisocial personality disorder. Social risk factors for drug abuse and addiction include male gender, being between 18 and 44 years of age, Native-American heritage, unmarried marital status, and lower socioeconomic status. According to statistics by state, people residing in the West tend to be at higher risk for chemical abuse or dependency. While men are more at risk for developing a chemical dependency like alcoholism, women seem to be more vulnerable to becoming addicted to alcohol at much lower amounts of alcohol consumption.

Parenting Services for Families Affected by Substance Abuse
Until the late 1980s, most substance abuse treatment programming was based on a model of service for the single male, with little attention paid to parent-child relationships or indeed to other familial or affiliative relationships [Finkelstein 1996]. Few treatment programs existed for women, and most of those that did exist were also based on this "single individual" model. At the same time, the child welfare service system and the substance abuse treatment system, often serving the same clients, interacted peripherally, and it was uncommon to find joint program or service planning [Finkelstein 1993, 1994].

In the late 1980s, two factors arose that altered this picture. One was the growing recognition that substance abuse treatment for women had to address relational issues, including parenting, to fully respond to women's needs and therefore promote successful treatment outcomes. At nearly the same time, the crack "epidemic" raised serious concerns about the effects of perinatal exposure to drugs and the need to provide specialized substance abuse treatment for pregnant and parenting women. This "epidemic" highlighted the fact that a large proportion of child welfare caseloads were families affected by substance abuse, a fact that continues to be true, with estimates that up to 80% of the caseloads are currently affected by substance abuse [CWLA 1998].

The demonstration project, which was the impetus for the development of this program, was innovative in its integration of parenting and parent-child services into substance abuse treatment. One effect of this integration was to increase coordination and planning with child welfare agencies serving the same families. Initially this coordination occurred between the programs involved in the demonstration project and local child welfare agencies. The demonstration project, however, heralded an increase in substance abuse treatment programs serving women with children and families, leading to more systemic coordination. In light of the time limits imposed by the Adoption and Safe Families Act (EL. 105-89) and the steady high percentage of child welfare involved families affected by substance abuse, improvement and expansion in coordination and joint service planning becomes critical.

Development
The Nurturing Program for Families in Substance Abuse Treatment and Recovery (the "program'), is an outcome of the parenting component of a Center for Substance Abuse Prevention demonstration project, the Coalition on Addiction, Pregnancy and Parenting (CAPP). The CAPP project, now known as the Institute for Health and Recovery (IHR), included the design, implementation, and management of a program of parenting and parent-child services at two women's residential substance abuse treatment agencies in Massachusetts. The goals of this component were to improve parenting skills, promote child development, and enhance parent-child relationships to improve treatment outcomes and reduce risk of relapse as well as to reduce developmental or abuse/ neglect risks to children. This project specifically focused on integrating successful treatment with improved parenting skills through enhancement of family relationships.

Families affected by substance abuse benefit in several ways from developing nurturing family relationships [Camp & Finkelstein 1997; de Cubas 1993] and particularly from enhancing parents' substance abuse treatment. Treatment and relapse prevention reports emphasize the importance of supporting the ability to form and maintain mutual and empathic relationships; the ability to experience success and enjoyment as parents; and the ability to cope with daily life stresses as crucial programmatic components [Bry et al. 1998; Camp & Finkelstein 1997; Castellani et al. 1997; Van Bremen & Chasnoff 1994].

For parents, family life and family relationships are critical areas for building coping skills. Incorporating these areas of concern into treatment programs can promote successful treatment and reduce relapse risk by keeping parents in treatment longer, as well as by increasing their self-esteem and sense of competence as parents [Camp & Finkelstein 1997; Chassin et al. 1991; U.S. Department of Health and Human Services 1999; Van Bremen & Chasnoff 1994]. Promoting nurturing parent-child relationships reduces both the risk of substance abuse for both parent and child, as well as intergenerational patterns of violence, abuse, and neglect.

The CAPP project selected the Nurturing Program for Parents of Children Birth to Five Years Old, by Stephen Bavolek, Ph.D., for use in the structured parenting skills group, one component of the program of services. The Nurturing Program has a well-established history as an effective intervention for improving parenting skills and reducing risk of child maltreatment, as well as a validated, reliable measure of effectiveness instrument, the Adult Adolescent Parenting Inventory (AAPI).

To make the Nurturing Program more responsive to the needs of the target population--parents in substance abuse treatment--strategic modifications were undertaken:

• To respond to the range of literacy levels and learning styles (52% of participants had not completed high school), formal didactic components of the Nurturing Program were reduced, and more experiential exercises were designed and implemented to allow for more effective learning for participants better able to express themselves through art, play, and interactive activity.
• Because a high number of participants had experienced childhood abuse and neglect (40% reported at intake that they had experienced sexual abuse in childhood; 37% reported that they had experienced physical abuse), additional material was developed to enhance parents' experience of nurturing through play, meditation, and self-expression, for example.

These adaptations addressed important intergenerational factors associated with substance abuse and with child abuse and neglect, the transmission of patterns of child maltreatment, and the increased risks of alcohol or drug abuse faced by children of substance-abusing parents. The adaptations also maintained adherence with the core domains of the Nurturing Program, that is: (1) enhancing appropriate developmental expectations; (2) increasing empathy for children's points of view; (3) valuing and using alternatives to corporal punishments; and (4) establishing and maintaining appropriate roles.

The modified version of the Nurturing Program was successfully implemented during the span of the demonstration project (1989 through 1995). Evaluation of the effects of the parenting program yielded encouraging findings, as reported in Camp and Finkelstein [1997]. Effects were measured to determine whether participants who completed the Nurturing Program exhibited improvement in parenting knowledge and attitudes and how the women who completed the Nurturing Program assessed its impact.
- Moore, J., & Finkelstein, N. (Mar/Apr 2001). Parenting Services for Families Affected by Substance Abuse. Child Welfare, 80(2).

- Dryden-Edwards, R., MD, Conrad Stöppler, M. (n.d.). MDDrug Abuse and Addiction. Retrived from: http://www.medicinenet.com/drug_abuse/article.htm

- Enoch, M., M.D., M.R.C.G.P., & Goldman, D., M.D. (n.d.). American Academy of Family Physicians. Retrieved from:
http://www.aafp.org/afp/2002/0201/p441.html

- LaMance, K. (n.d.). Drug Crime Punishments and Enhancements. Retrieved from: http://www.legalmatch.com/law-library/article/drug-crime-punishments-and-enhancements.html

Peer-Reviewed Journal Article References:
Carmody, T. P., Delucchi, K., Simon, J. A., Duncan, C. L., Solkowitz, S. N., Huggins, J., Lee, S. K., & Hall, S. M. (2012). Expectancies regarding the interaction between smoking and substance use in alcohol-dependent smokers in early recovery. Psychology of Addictive Behaviors, 26(2), 358–363.

Eddie, D., White, W. L., Vilsaint, C. L., Bergman, B. G., & Kelly, J. F. (2021). Reasons to be cheerful: Personal, civic, and economic achievements after resolving an alcohol or drug problem in the United States population. Psychology of Addictive Behaviors, 35(4), 402–414.

Ennis, E., & Trearty, K. (2019). Attachment orientations and adult alcohol use among those with childhood adversities. Journal of Individual Differences, 40(4), 187–193.

Field, M., Heather, N., Murphy, J. G., Stafford, T., Tucker, J. A., & Witkiewitz, K. (2020). Recovery from addiction: Behavioral economics and value-based decision making. Psychology of Addictive Behaviors, 34(1), 182–193.

Grant, D. S., & Dill-Shackleford, K. E. (2017). Using social media for sobriety recovery: Beliefs, behaviors, and surprises from users of face-to-face and social media sobriety support. Psychology of Popular Media Culture, 6(1), 2–20.

Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., Miller, M., Burlew, K. A., Hodgkins, C., Carrion, I., Vandermark, N., Schindler, E., Werstlein, R., & Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents. Journal of Consulting and Clinical Psychology, 79(6), 713–727.

QUESTION 14
What are the four core domains of the Nurturing Program?
To select and enter your answer go to Test.