Objective 10
To describe your own attitudes and values regarding
substance use disorders.
This objective is different than the others in that there is no objective
data that can really help you assess your own attitudes and values regarding
substance abuse. It is, however, important to review your thoughts on this
topic because of the potential problems a lack of understanding in this
area can create.
Your attitudes about substance abuse reflects your philosophy or opinions
on the subject and probably dictates your behavior toward your patients
vis-à-vis the topic of substance abuse more than any other issue.
Your attitude can be affected by many things - some professional and
some personal. Whatever you can do to clarify your values on these issues
will pay dividends. Here are a few questions you may ask yourself from time
to time to help clarify your thoughts on this subject.
Professional:
- How important is it to ask your patients about their alcohol, smoking
and drug taking behaviors during a routine physical exam?
- How much drinking is too much from your point of view?
- Is there really anything wrong with a 25 year old using a little marijuana
from time to time?
- How serious, from a medical standpoint, is the fact that a 17 year
old female patient is smoking?
- How serious, from a medical standpoint, is the fact that a 75 year
old male patient is smoking?
- If a female patient drinks more than a drink a day, what medical concerns
would you have?
- If you believe your patients should change some of their habitual
behaviors, how confident do you think you can be that they actually will
change those behaviors?
- How confident do you think you can be about your ability to help your
patients change self-defeating habitual behaviors?
- How important is it that you know all the street terms and all the
characteristics of the street drugs used by addicts to really help a drug
dependent patient?
- How important to your practice is personal contact with referral sources
in your community?
- How serious a problem is substance abuse in our society?
Personal:
- What is different about the way you think about alcohol, tobacco, and
other drugs compared to your parents?
- What effect do you think your childhood experiences have had on your
current use patterns?
- How many drinks a day can you consume without creating medical or social
difficulties?
- How much smoking can you do without creating medical difficulties.
- Is it possible to use other drugs illegally without causing you personal
harm either medically or socially?
- Are there any alcohol, tobacco, or other drug related behaviors that
you would like to change?
- If the answer to the above question was yes, do you feel you know how
to get help in your efforts to change?
- Would the fear of repercussions keep you from seeking help?
- If you had a colleague who was in trouble with alcohol or other drugs
what would you do to help?
- How important an issue is substance abuse to you and your family?
- What is the worst thing that could happen to you relative to your alcohol,
tobacco, or other drug use?
- What is the best thing that could happen to you relative to your alcohol,
tobacco, or other drug use?
There are no "correct" answers to the above questions. If answered
honestly, the answers reflect what is true for you. When you find that your
opinion is out of step with the information presented in this course or
with commonly accepted medical or social positions it would be very worthwhile
to review the data concerning these issues.
We sometimes hold opinions created by events in our lives that are far
less than scientific and that involve extraordinary levels of generalization.
Checking out these areas by searching through data created by legitimate
researchers with designs you accept can have enormous influence on your
attitudes surrounding the topic. It sometimes take courage to change an
attitude that is keeping you from providing the best medicine that you possibily
can but if you have the courage to challange your beliefs, you will surely
have the wisdom to know when change is indicated.
Members of Alcoholics Anonymous often repeat the following words:
God grant me the serenity
to accept the things
I cannot change,
the courage to change
the things I can,
and the wisdom to know
the difference.
How do these thoughts apply to your personal
life?