Substance Abuse Treatment and Mental Health
Modern society presents more opportunity for substance abuse than ever before. Psychoactive substances traditionally available include alcohol, opiates (pain killers), heroin, cocaine, methamphetamine, benzodiazepine (Xanax), and marijuana. Modern synthetic compounds such as ecstasy, spice K2, GHB, bath salts, synthetic drugs and home made meth labs have dangerous and deadly consequences. These chemical compounds are constantly being reformulated in an attempt to stay one step ahead of the law. Often people get addicted to the very drugs originally prescribed to help them deal with addiction in the first place, such as suboxone, subutex and methadone.
The connection between drug/alcohol abuse and the criminal justice system is well documented. Judges, district attorneys and other prosecutors know that more than 80% of felony charges are alcohol or drug related. Experienced criminal defense attorneys must deal with the client’s substance abuse issues that led to the arrest. We partner with licensed mental health professionals and recognized treatment facilities in appropriate situations. The questions presented below are a good place to start in evaluating a person’s substance abuse and chemical dependancy issues. The following questions have been adapted from the Diagnostic and Statistical Manual of Mental Disorders. They are presented as a reality check for defendants and their families in determining whether the defendant has a substance abuse or chemical dependancy issue and whether treatment may benefit.Some Questions Regarding Substance Abuse:
- Do you spend a lot of time drinking or doing drugs? Do you have hangovers or feel sick the next morning?
- Do you crave alcohol or drugs so much that you can’t think of anything else?
- Does your alcohol or drug use hinder caring for home and family? Does it make job or school duties more difficult?
- Do you keep using alcohol or drugs knowing it interferes with important relationships such as friends, family or spouse?
- Have you reduced or discontinued activities you used to consider important so you could drink alcohol or use drugs?
- Has your drug or alcohol use endangered the safety of you or others? Some examples include impaired driving, sharing needles, or having unsafe sex.
- Have you experienced a memory blackout after drinking or drugging - a memory loss occurring under the influence? Have you been told you did something during a blackout you would not ordinarily do? Examples include inappropriate conversations, having unprotected sex, driving impaired or gambling.
- Does your alcohol or drug use cause health problems, cirrhosis of the liver, and/or mental health issues such as anxiety, depression or memory loss?
- Do you increasingly have to ingest more alcohol or drugs to achieve the same effect you used to have? Do you find that the amount you used to consume now has less effect?
- When the effects of alcohol or drugs diminish, do you experience withdrawal such as difficulty sleeping or waking, restlessness, shakiness, nausea, sweating, rapid heart beat, or seizures? Have you heard or seen things that were not present (hallucinations)?
- Has your drug use (including alcohol) led to legal problems that harm your family relationships (such as domestic violence), your job (such as DUI) or your freedom (any felony)?
If someone’s life has become unmanageable due to substance abuse/chemical dependancy, treatment may be the answer. Treatment offers the best alternative for interrupting the substance abuse/criminal justice cycle for people with drug or alcohol problems. Many times the first step is a substance abuse and chemical dependancy assessment by a trained professional.
If indicated, the treatment plan may include detox, drug testing, early intervention, outpatient treatment, or intensive outpatient treatment. Inpatient treatment can include partial hospitalization, full inpatient treatment, or medically managed inpatient treatment. After care can include AA meetings, NA meetings or other recovery groups. Professional therapists can provide an individualized plan such as cognitive behavioral therapy, in which negative patterns of thoughts and feelings about self and environment are challenged in order to alter unwanted behavior patterns.
Mississippi has a broad spectrum of inpatient and outpatient rehabs, including 12 step and faith based approaches. Some are able to adjust the cost based on income. Mississippi’s Department of Mental Health serves each county through community mental health centers which provide alcohol and drug rehabilitation and treatment services. Drug Courts take a collaborative problem solving approach, integrating treatment, rehabilitation, and accountability, with the goal of ending criminal activity. Long term therapeutic alcohol and drug treatment is also available while serving a sentence in the Mississippi Department of Corrections.Military Veterans and the Invisible Wounds of War:Post Traumatic Stress Disorder and Traumatic Brain Injury
When a person witnesses traumatic or stressful events, a delayed response can result. Experiencing or confronting traumatic events can result in feelings or fear helplessness or terror. The military, police officers, and first responders are all subject to Post Traumatic Stress Disorder (PTSD) in their daily jobs. Ordinary people who experience or confront stressful events such as survivors of hurricanes, violence, child abuse, and any type of traumatic loss can suffer recurrent, involuntary, intrusive memories of the event. Distressing dreams can haunt the victim. Flashbacks, hallucinations and other extreme dissociative reactions can continue to haunt the victim long after their traumatic origins cease.
Sometimes the victim tries to avoid events associated with the trauma. Other negative reactions include memory loss, negative emotional state, diminished interest in significant life activities and suppression of positive emotions such as happiness, satisfaction and loving feelings. Sometimes the PTSD survivor exhibits irritable behavior and angry outbursts including verbal or physical aggression, self-destructive behavior, difficulty with concentration, sleep disturbance, re-experiencing the event, avoiding remembering the event and hypervigilance. If these behaviors are triggered by traumatic events, PTSD should be investigated. Individuals with PTSD can re-experience the trauma through flashbacks, nightmares and intrusive memories including images and sounds of the event. Veterans with PTSD may also feel and react as if they were in constant danger, experiencing hypervigilance or hyperarousal.
If a person arrested for a crime has been exposed to traumatic events there may be a link between the crime and PTSD. Victims of PTSD may try to avoid painful thoughts by numbing themselves to the outside world. Responses to the pain of PTSD can include excessive alcohol use, abusing prescribed medication, and self medicating with illegal drugs. When a veteran diagnosed with PTSD is arrested and charged with a drug crime, it is important to look to the root cause of the drug use and also get help for the PTSD.
Traumatic Brain Injury (TBI) is a head injury occurring when a sudden trauma cases injury to the brain. Documented TBI symptoms experienced by veterans can include difficulty thinking, memory problems, attention deficits that did not exists before the TBI, mood swings, frustration, headaches, fatigue and numerous other symptoms. PTSD and TBI are often treated together since the symptoms of each are similar, and many veterans with TBI also suffer from PTSD.
Veterans and other people who bear the scars of PTSD or TBI may try to self medicate or over medicate using their prescriptions. In order to deal with PTSD flashbacks they find disruptive or uncomfortable, veterans suffering physical and mental disorders may be prescribed medication to help them cope. Sometimes over medicating leads to buying drugs on the street in an attempt to self-medicate. For example, the depressed veteran may use marijuana to numb the pain. Veterans may turn to alcohol to relieve anxiety, or escape vivid flashbacks. Veterans may abuse Xanax, Valium, or other benzodiazepines to numb the symptoms or prevent panic attacks. Veterans with low energy levels or lack of motivation may abuse Adderall, crystal meth, or cocaine to enhance energy levels. Depression can follow as the effects of these drugs wear off. Abusing one or more controlled substances can quickly lead to a felony arrest. When a veteran suffers from service connected PTSD or other disorder, we work with the VA to coordinate treatment and the veteran’s legal defense.Mental Illness and Substance Abuse
Defense of a mentally ill client is complicated by substance abuse. The best Mississippi criminal defense lawyers will add a qualified mental health professional to the defense team either for treatment or to assist in the investigation. Recovery begins with treating the addiction and the mental health problems.
The probability that mentally ill patients will engage in criminal or violent behavior depends on the severity of mental illness and is increased by their use of psychoactive substances. When appropriate, dual diagnosis treatment combines treatment for mental illness and substance abuse disorders. Cognitive behavioral treatment addressing criminal thinking, anger or impulse control, and other pertinent behavioral issues can lower crime rates among those with mental illness.Impulse Control Disorder
People with impulse control disorders have difficulty resisting impulsive acts that may harm themselves or others. These impulsive behaviors can include uncontrolled violence directed at domestic partners and others, inappropriate sexual behavior, arson, and stealing. For example, where some people may argue, someone with an anger or impulse control disorder may react with aggression out of proportion to the circumstances. They may fly into a rage resulting in injury or serious property damage and legal consequences. Drinking and drugs can aggravate impulsive behavior. Substance abuse can significantly magnify violent behaviors resulting in criminal charges.Bipolar Disorder
Bipolar disorder, formerly known as manic-depressive illness, is a disorder of the brain exhibiting as severe shifts in mood, energy, activity levels and ability to conduct daily activity. Manic phase can include at least one week of elevated, expansive or irritable mood, talkativeness, racing thoughts, inflated self-esteem or grandiose behavior, decreased sleep, extreme distractibility or engaging in risky behavior. Depressive symptoms can include extreme feelings of sadness, despondency or pessimism. During the manic phase of bipolar a person may engage in risky behavior such as unprotected sex, drunk driving, shoplifting, or spending excessive amounts of money shopping or gambling. While in a depressive bipolar phase, the person may not be able to perform usual activities such as work, childcare, or personal hygiene. There is also a real risk of suicide during a depressive phase.
Persons with untreated bipolar disorder may try to self medicate, for example, using large quantities of alcohol to sleep after a severe manic episode. Using alcohol or street drugs can lead to a felony arrest. The resulting legal problems can complicate correct diagnosis and treatment.
It is impossible to list every mental disorder and complication from drug abuse. Substance abuse can significantly magnify violent behaviors in people with mental illness. Voluntary intoxication is not a legal defense to a criminal charge. Consuming illegal drugs complicates the defense of a person with mental illness.
If you or a loved one has been arrested because of substance abuse or chemical dependency, help is available. Military veterans may present special challenges in addressing substance abuse secondary to their service connected injuries. People with a mental disorder and a drug problem may need dual treatment to prepare for court. Contact the Law Office of Rufus Alldredge, 1921 22nd Avenue, Gulfport, Mississippi 39501, telephone 228.863.0123.