Discrimination of the AIDS population:
the author gives an analogy concerning discrimination of the AIDS
population. It is under “Who Is Responsible for AIDS?” in the second
paragraph. Post your reaction to his analogy and comment on his statement
Discrimination of the AIDS population: SubstanceAbuse Treatment: Shouldhuman service professionals be required to have additional certification in thetreatment of this population? Why or why not?
Full instructions and book attached
Book
HHS 435 Cont Issues, Trends, Health Law Ethics in H & HS
Human Services Contemporary Issues and Trends 3rd Edition
Edited by
Howard S. Harris
David C. Maloney
Franklyn M. Rother
Please answer both discussion questions separately. Discrimination of the AIDS population and
Substance Abuse Treatment
Discrimination of the AIDS population
In Chapter 13 of the text, the author gives an analogy concerning discrimination of the AIDS
population. It is under “Who Is Responsible for AIDS?” in the second paragraph. Post your
reaction to his analogy and comment on his statement “Groups of disposable people”. What
strategies/tactics can the Human Service worker apply/utilize to combat this type of attitude?
Chapter 13
Who Is Responsible for AIDS?
While the U.S. Constitution is thought to protect all Americans, those of us in human services
know well that discrimination continues in our society. Examples include the Rodney King
beating in Los Angeles in 1992, the passage of Amendment 2 by Colorado voters in November
1992, and the enormous public reaction to President Clinton’s 1993 efforts to allow openly gay
men and lesbians into the military.
In the example of AIDS, this discrimination manifests itself as a form of “blaming the victim.”
According to this way of thinking, people who contract HIV do so because they violate society’s
norms by either using needle drugs or engaging in illicit or socially unaccepted (gay,
extramarital, or premarital) sex. Some groups in our society then find it easy to adopt the position
that people bring HIV on themselves. Since individuals are responsible for their own behaviors,
some of which result in contracting HIV, these individuals are ultimately responsible themselves
for becoming ill. Thus, society should have no responsibility toward them. The rule then would
seem to be this: Either obey society’s rules, or we don’t care if you sicken and die. Taken to its
logical extreme, this should mean that we refuse to provide treatment for victims of skin cancer
who had spent time trying to get a tan, for victims of lung cancer who had smoked, for victims of
cirrhosis who were heavy drinkers, and so on. So, we essentially would have groups of
disposable people.
When translated into policy, this could mean that people with HIV and AIDS should be openly
discriminated against in housing or employment or public accommodation. It could mean
reductions in access to health care benefits. It could mean the stripping of civil liberties such as
the right to privacy. People with HIV and AIDS could find that their health status is public
information. Because the disease initially affected gay men almost exclusively, public attitudes
toward homosexuality are closely tied to antipathy toward PWAs.
Some segments of American society would immediately stop all HIV education, relying instead
on exhortations that there be no sex except between legally married heterosexual couples.
However noble or ideal that goal might seem to be, it ignores the data on sexual activity in
America.
As long as the HIV epidemic continues, these issues will be debated. As a human service worker,
you will find yourself in an important role. You could be asked to provide expert testimony in
court. You may be interviewed by people from the media. At the very least, you are a voter who
should be well informed about the issues.
CONCLUSION
We reiterate that you will almost certainly work with people living with HIV and AIDS if you
become a human service worker. This work can be richly rewarding, as can any human service
work. But, because it involves life-threatening illness and death, it can be debilitating as well.
Only you can decide whether specializing in this area would be a good choice for you.
We urge you to consider a career working in one of the many kinds of AIDS organizations. To
make such a decision, you must carefully examine your attitudes toward sexual orientation,
toward members of racial and ethnic minority groups, and toward people who use needles. If you
are disapproving or squeamish, either work through your issues or select another area in which to
specialize. Do not enter this line of work as a means for improving your attitudes toward gay
people, members of minority groups, or drug users, or for proselytizing or preaching. People
with HIV bring unique problems. They need your help and support. It would be unethical for you
to use them for your own purposes.
To help you decide whether HIV work would be a good choice for you, begin to volunteer in a
setting that provides services to people living with HIV and AIDS. Answer the telephone, raise
money through phone-a-thons or a Walk for Life or other means, stuff envelopes, staff the
hotline, or become a buddy. Interview people who work in such agencies. Get to know other
volunteers. You can gain valuable additional experience by doing a field placement or internship
working with people living with HIV and AIDS. Even if working with people living with AIDS
is not your preference, you will undoubtedly work with people who are HIV positive, so you
must learn as much as you can about the disease and the needs of people who have it.
Substance Abuse Treatment
The treatment of substance abuse is one of the most complicated behaviors to bring about
effective and lasting change. The author states in Chapter 15: “Failure to identify the
contributing and resulting connections between substance abuse and the client’s presenting
problems with health, the law, money, work, school, society, family, and self will spell a decisive
failure in care, however well packaged the plan and well intentioned the delivery”. Should
human service professionals be required to have additional certification in the treatment of this
population? Why or why not? Support your discussion with a minimum of one scholarly, peerreviewed source that was published within the last five years and cited according to APA
guidelines.
Chapter 15
CHALLENGES FACED BY HUMAN SERVICE WORKERS
The human service worker stands, as a generalist, in the middle of a network of providers, ready
to work cooperatively with the many specialists assessing, developing treatment/service plans,
delivering care, evaluations, and outcomes. In the arena of alcohol and drug abuse, the key
challenge to the worker remains the same: achieving the earliest detection for possible
prevention. Yet in the reality of the service delivery systems, the challenge almost always
involves the detection of intoxication, the history of abuse, the possibility of dependence, and/or
risk as victim or victimizer. No accurate or appropriate care can be designed and provided in any
context without knowledge of the effects of drugs on a client’s life. Failure to identify the
contributing and resulting connections between substance abuse and the client’s presenting
problems with health, the law, money, work, school, society, family, and self will spell a decisive
failure in care, however well packaged the plan and well intentioned the delivery. The old
psychiatric rule “diagnosis predicts prognosis and therefore directs treatment” applies here as
well.
The first challenge, then, is one of accuracy. However, much client care may be a matter of
heart; it must be guided by knowledge and experience. Accurate knowledge of the psychoactive
substance use disorders and their associated intoxication and withdrawal syndromes arms the
worker with necessary information to intervene at the earliest possible moment. The continuum
of care reaches from direct immediate crisis intervention to consultation and referral as required.
The second challenge lies in the subjective domain, in the human service worker’s own personal
story. Few individuals can claim never to have been touched by the effects of substance-induced
behaviors, though they might claim, for themselves, lifelong abstinence. Whether in personal,
social, or professional experiences, the human service worker will have accumulated learned
responses to this population. The challenge of empathic acceptance, of healthy emotional
distance, or disidentification of a client-enhancing response to countertransference calls for clear,
helpful supervision. Whether the service being delivered to the client entails modest assistance
with some agency paperwork or involves the complex, long-term work of case management, the
energy at the meeting of client and practitioner will generate the atmosphere of change. It
therefore becomes an inner challenge for the worker to know her or his own story and to use that
level of awareness to promote the client’s good and to attempt to cause no harm.
The third challenge pertains to the temptation of the human service practitioner to view himself
or herself as competent to function as a substance abuse counselor despite a lack of specialized
academic training and clinical experience. The treatment of substance abuse and dependence is a
multidisciplinary enterprise. The work of a substance abuse counselor is defined by observable
and measurable competencies. For the human service worker who serves an addicted population,
it is an ethical imperative to know one’s limits of competence and role within the agency and to
consult and refer as necessary.
The worker who is unfamiliar with the neurological impairments caused by particular substances
abused would be in danger of placing the client, self, and others in physical and/or psychological
jeopardy. Depressants, stimulants, narcotics, and hallucinogens present their own sets of
impairments and their own relative levels of danger. Confusion about the client’s antecedent or
resultant developmental and personality disorders would make the adoption of an individualized
helping style difficult. Early trauma in combination with many years, even decades, of substance
abuse exacts heroic transformational work on the part of the recovering person. Overestimation
of the addicted person’s ability to stop using and become sober without sufficient time for
emotional healing and behavior change would lead to errors in the selection of strategy, in the
expectation of outcomes, and in the fundamental process of defining the real problems. The
nature of the disorder and of rehabilitation leads to paradoxes for the recovering addict as well as
for the human service practitioner.
Again, the history of drug use gives us a clue about the paradoxical nature of psychoactive
substances, of the disease of substance addiction, and of the recovery process. The ancients and
the alchemists taught that nature cured disease with either similars or opposites, depending on
the illness. Substance abuse and dependence is such a disease. The substances themselves
produce their opposites: depressants can rebound into anxiety; stimulants can plunge into
depression; narcotics produce their own pain; hallucinogens can lead to loss of self. That which
the user originally sought through partaking of the drug eventually eludes the abuser. The drug
exacts due payment for all experiences—soothing, exciting, painless, or expansive. All that was
beyond the ego’s humble ability to integrate into the psyche and beyond the body’s physiological
capacity to metabolize into vital energy returns with a vengeance.
The enslaving addiction to the drug releases the abuser to an opposite dependence, binding her or
him to a committed pursuit of inner freedom hard won by selfless courage. In the tradition of
recovery, the paradox of the twelve-step program of Alcoholics Anonymous (and Narcotics
Anonymous) describe that which will nurse the recovering person back to sanity with an elixir of
opposites—a bitter medicine that many will reject. No recovery program anywhere can sidestep
the necessary laws of nature that direct bodies, minds, and souls from illness to health.
The client’s life calls for a complete turn-around—nothing less will do. The cleverness and
cunning that characterized the addiction must become slowness and carefulness, accepting the
wisdom of another, allowing the unshakable inner self to put aside the false grandiose ego
projected by the substance. A new life begins only with the death of the old one. It is ultimately
the paradox of life and death because substance dependency is a matter of life and death.
HUMAN SERVICE RESPONSES TO SUBSTANCE ABUSE
The human services respond to the problem of addiction in society in three ways: education,
prevention, and treatment. The choice of response is determined by the level of addiction, which
is the target of the approach. Limiting considerations to the individual, the human services
distinguish between the person who has never used drugs for recreation, the one who only rarely
uses chemicals for recreation, the person who uses frequently and whose abuse leads to some
personal and professional problems, the individual who is dependent to the point of resulting
medical complications, and the small percentage of individuals who, in their chemical
dependency, are also socially isolated and face predictable death. Because chemical dependency
is potentially life threatening, the human services respond according to the immediacy of the
danger to self and others.
Education
Successful drug education programs have incorporated in their materials and services the
knowledge, attitudes, and behavior necessary to optimize the choice of a drug abuse–free life.
Some programs emphasize convincing the audience of the dangers of drugs, whereas other
programs underline the objective facts about the substances, advocating neither abstinence nor
reasonable use. Other programs utilize the power of identification with a noteworthy person in
recovery to score a point with the listeners or viewers. Still other programs, especially those
geared toward the school- and college-age population, are even more direct in their approach,
providing training in assertively resisting encircling pressures.
Prevention
Prevention does not only refer to those persuasive efforts aimed at stopping abuse before it starts.
It also involves those interventions aimed at signaling to a user in the early stages of abuse that
continued use could result in damaging consequences. Early diagnosis with crisis monitoring,
crisis intervention, and referral are such interventions. For those individuals who are in the later
stages of abuse that lead to dependency, the prevention efforts address the goal of halting the
slide to that conclusion. In this instance, intervention
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