Monday, June 17, 2019

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Hollywood's Hang Up

Hollywood is a medium sized city in Broward County in the Southeastern part of Florida. Being in close proximity to the larger urban centers of Miami and Fort Lauderdale, Hollywood has experienced some residual problems that frequently occur in larger cities, such as drug trafficking and other crimes. Furthermore, Hollywood’s rapid and steady growth since its founding in the 1920s have forced the city to manage these ‘big-city’ problems at a much faster rate than might be expected of other similar-sized cities in the United States. As a result, Hollywood has faced some challenges managing and meeting the substance abuse problems the community faces and many individuals do not receive the inpatient treatment they need. This article discusses drug abuse and crime rates in Hollywood, as well as drug rehabilitation and treatment options.

Hollywood Demographic Characteristics

Hollywood has a population of close to 150,000 people, a figure that has risen steadily since its original foundation in 1925 and first census in 1930. The city is very diverse racially, with under 50% of residents identifying as White, 33% being Hispanic or Latino, 17% being African American or Black, and slightly more than 2% being Asian. The remainder of residents primarily consist of Native Americans, Pacific Islanders, multiracial, or identifying as another race. The largest age demographic is 25 to 44, which represents about 31% of all residents of Hollywood. Evidence suggests that the 25 to 44 year old age group experiences the highest rates of drug usage, trafficking, and related crimes of any, serving as one potential contributor to high rates of drug and alcohol problems in Hollywood. However, the median income in the city is not close to the federal poverty line, making income level a relatively insignificant contributor to drug usage. The median household income is $40,000 and the median family income is more than $55,000, which are both well above the federal poverty line of $15,000. Individual males earn approximately $33,000 and females earn about $22,000 annually. Close to 10% of families and more than 13% of individuals in Hollywood live below the federal poverty line, with 18% being under the age of 18.

Drug Abuse Rates and Crime Statistics

The Commission on Substance Abuse produced a report on drug abuse trends in Broward County 2016, illustrating those types of substances most strongly impacting the city of Hollywood. According to the report, the most frequently occurring problems in Hollywood regarding substance use include underage alcohol usage, tobacco, marijuana, prescription based opiates, heroin, cocaine, and methamphetamines. However, in many areas, Hollywood has experienced some positive trends in regards to drug and alcohol abuse. Binge drinking in youth has experienced a decline, despite alcohol being the most commonly occurring source of substance abuse treatment in Broward County.

About one third of all patients entered into treatment for substance abuse in Broward County is in regards to alcohol. Tobacco usage has declined, while marijuana usage has increased (particularly in youth). Like many locations in the United States, Hollywood has experienced a sharp increase in opiate usage, including both prescription based painkillers and pure heroin obtained on the streets. The increase in the latter is believed by many to be attributable to the former. As patients become addicted to prescription based painkillers obtained legally to manage medical problems, they gradually shift to heroin because of its lower cost and easier access. As a result, Hollywood, Florida drug and alcohol rehabilitation centers have seen a considerable increase in the rates of admissions for opiates and heroin, both of which typically require a detoxification period. Mexico is also believed by many to be a contributor to high rates of heroin usage in Hollywood because of the city’s southern location and proximity to the country.

Much of the crime and drug trafficking in Hollywood is believed to be regulated by organized criminal rinks originating in Mexico. Hollywood is also a relatively dangerous place to live, scoring a 40 out of 100 in terms of violent crime risk, compared to the national average of 31. In particular, property crime rates are particularly high in Hollywood, which is often linked to drug related activity.

How Substance Use Has Impacted the Community

It is clear that increases in heroin and opiate usage, as well as already high rates of alcohol abuse and underage drinking, are the most pressing substance usage issues in Hollywood, Florida. Property crime has increased in the city, partially due to side effects of drug related activities, including the theft of items to pay for drugs. Violent crime is also related to drug activity, as organized drug trafficking rings engage in turf wards and violence in order to establish territory for distribution and financial gain. On a positive note, Hollywood has made a rigorous effort to engage in long-term prevention activities to reduce rates of drug and alcohol usage, particularly in youth. The development of new parks and recreational activities and increased drug prevention and education efforts in schools have helped reduce some substance use problems in the community (e.g. tobacco). Furthermore, Hollywood has built several new drug and alcohol treatment centers since the turn of the 21st century to fulfil many of the treatment needs previously encountered by residents. Inhabitants of Hollywood now have several inpatient and outpatient options to choose from to manage substance abuse disorders and chemical dependency.

Risk Factors for Substance Use

Regardless of the location, there are many risk factors for substance use. These can generally be categorized as genetics, brain characteristics, psychological factors, environmental contributors, and early usage. Those with familial histories of drug and alcohol addiction are more likely to become addicted themselves. Stress and personality factors (e.g., impulsivity, depression) can lead to increased risk of substance abuse. Environmental factors like community socioeconomic status and crime can contribute to increased risk of substance use. While Hollywood does not have a socioeconomic makeup that would typically be considered to be a risk factor for substance abuse, the high rates of property and violent crime do make the location particularly conducive to the development of substance abuse disorders. A greater number of addiction risk factors present greatly increases the risk of developing a substance abuse disorder.

Causes of Substance Use

Substance abuse typically undergoes a process of experimentation to addiction. Any of the risk factors above can lead to substance use experimentation. A substance abuse disorder occurs after, through a period of repeated usage, a chemical dependency on the substance is developed based on the pleasure response the substance produces. Once a chemical dependency is developed, detoxification and professional treatment is likely needed to promote full recovery.

Signs of Drug Abuse and Addiction

Signs of drug abuse and addiction vary based on the substance being consumed. However, general behavioral patterns can serve as an indication of substance use, such as changes in mood or affect, sleep disturbances, fluctuations in spending habits and financial management, relationship challenges, and variance in performance and work or school. These are in addition to physical and psychological signs that are specific to the substance of choice. For example, a sign of marijuana usage is bloodshot eyes, while alcohol dependency often produces a yellowish skin tone due to damage of the liver.

How to Tell if Someone is Using

In any case of drug or alcohol addiction, family and friends play critical roles in identifying the problem and promoting early intervention. This is because many of the signs of drug and alcohol addiction are based on not the actual behavior patterns themselves, but a rapid change in behavior that is only detectable to people with close knowledge of that person’s habits. Any unusual and otherwise unexplained change in behavior can be an indication of drug and alcohol abuse. Defensiveness when asked about drug and alcohol usage can also be a sign of a developing problem. Additional ways in which to detect if someone is using include problems at work or school, declining physical health, neglect of personal appearance, and financial problems. In any case, if a problem is identified, professional help should be sought as soon as possible because evidence suggests early intervention is critical for promoting long-term recovery.

Drug Treatment and Rehabilitation

While Hollywood, Florida does experience some challenges with drug and alcohol abuse, there are several highly regarded inpatient and outpatient treatment facilities available to residents with varying recovery needs. The close proximity to large urban centers and several universities and medical schools give Hollywood exposure to the most state of the art rehabilitation and treatment options available in the world. However, regardless of the type of intervention undertaken to promote long-term recovery, most drug and alcohol rehabilitation facilities utilize a similar process when guiding treatment. These include assessment, pre-intake, intake, detox, inpatient treatment, outpatient treatment, aftercare, and sober living. Each of these steps is discussed in more detail below.

Assessment

Assessment is the first stage of any drug and/or alcohol recovery program. This process consists of a drug and alcohol screening that is guided by a validated instrument (e.g., questionnaire) that can be used to determine if an addiction or substance abuse disorder is present. Both standard and non-standardized questionnaires can be used to obtain a comprehensive determination of the magnitude and type of problem that is present. A personal interview with a licensed drug and alcohol counsellor also completes the assessment process, which can be used to augment the quantitative data obtained from the screening process. Once the assessment process is complete, a referral is made to a particular treatment facility, type of intervention, and recovery approach.

Pre Intake

Following the assessment and referral, the pre-intake takes place at the recommended treatment facility, whether that be an inpatient or outpatient facility. The pre-intake consists of the completion of basic information about patient demographics, requests for alcohol or drug services, and any additional center-specific materials that can better inform the intake phase.

Intake

The intake phase of treatment is an elaboration of the pre-intake, and consists of a formal interview with a physician or licensed drug and alcohol counsellor. Based on information gathered from the pre-intake, the interview is structured to obtain a more thorough understanding of the patient’s treatment needs. This formal interview also consists of a patient medical and family history of drug and alcohol abuse. The combination of these intake phases lead to the creation of a formal treatment and recovery plan.

Detox

In some cases, detoxification may be necessary in order to removal chemical toxins from the body that contribute to continued physical dependency on a particular substance. Detoxification is the structured and supervised administration of an alternative and closely controlled substance to facilitate chemical toxin removal and stimulate psychological recovery as the patient manages physical and psychological symptoms of withdrawal. During this period, full residential care is needed to manage the sometimes traumatic and stressful symptoms that arise from chemical withdrawal.

Inpatient Treatment

Inpatient treatment is required in more severe cases of chemical dependency, and can consists of full residential care, partial hospitalization, or intensive outpatient treatment. Each requires some degree of residence and supervision in a treatment facility that enables professionals to closely monitor the patient during the early stages of withdrawal and recovery. An aim of full residential care is to manage physical symptoms of withdrawal and provide the physical and social support needed to prevent strong urges for relapse.

Outpatient Treatment

Outpatient treatment allows patients to engage in recovery while still managing daily lives, and is the most commonly used form of drug and alcohol abuse intervention. Outpatient care emphasizes psychological skill development and social support to enable patients to cope with symptoms of withdrawal and prevent relapse on their own.

Aftercare

Aftercare is the final state in recovery, and consists of a lifelong engagement in, or affiliation with, a drug and alcohol support group to provide ongoing relapse prevention.

Sober Living

Sober living is a philosophy that perpetuated throughout recovery and the ultimate aim of any drug and alcohol rehabilitation program. Sober living occurs when the patient autonomously demonstrates the capacity and skills to manage contributors to addiction and relapse, and also serves as a source of social support for other individuals undergoing addiction recovery.

Hollywood Needs Help

It is clear that Hollywood faces some drug and alcohol problems that have risen in recent years and significantly impacted the community. However, the presence of several highly regarded drug and alcohol treatment facilities serves as a sign of progress in this area and its effort to promote long-term prevention.

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