Marijuana in a Digital Age: A Potentially Unconscious Impairment

As the US government reviews enforcement of marijuana laws, the rest of the country is legalizing use state by state. The legalization of marijuana in some form spans 30 of our states with at least 12 more potentially on the horizon for 2018. As social workers, we need to traverse this changing landscape to help our clients, but what about ourselves? Legalization presents ethical issues for personal use by social workers. What do social workers need to know about technology and marijuana.

This might seem like a non-issue for social work professionals, after all, substance impairment during social work practice is against our ethical standards. I address this issue because of the ease in which technology allows social workers to practice even when not at a physical place of work and the new addition of a mood altering drug which may fly under the radar of professionals unfamiliar with its effects. The legal opening in some states and healing effects touted by people using THC make an attractive package for those never privy to this illegal substance. Some people who never used illegal substances may be curious. Others live memories of substance use in bygone days of yesteryear. These are not the substances being sold today.

Availability of THC opens the door for medical, psychological, and recreational use by social workers. Legalization paves the way for smoking, tinctures, edibles, and concentrates to an entire new market. While alcohol stays in the blood for 12 hours, THC can be in the blood for up to 336 hours.The high from smoking marijuana only lasts a couple of hours depending upon the amount used.  Ingestible THC stays in the system for a longer period of time with a more intense effect. A high from ingesting THC can last hours with the peak up to four hours after consumption. Documentation of effects, depending on the chemical composition, can last up to 24 hours.

Texting, emails, and HIPAA compliant phone apps and therapy online, open communication with clients more than the standard nine to five work day.  The effects of THC and a reduction in the standard boundaries technology affords us could open the door for mistakes on social media, or worse with a client. Before use be aware of the potential effects of use. SAMHSA describes the short-term effects of marijuana use which include "problems with memory and learning, distorted perception, difficulty in thinking and problem-solving, and loss of coordination." Addressing crisis situations by text or phone may be diminished. Auto-correct is a bad enough problem with normal texting. If there is a loss of coordination what message could be sent which could inadvertently cause harm? If emails and texts are a part of the client record everything you send has a potential for review or subpoena.

Due to the illegality of THC on a federal level, workplace law makes it a terminating offense to test positive on a drug screen. If there is a workplace incident, many organizations use drug testing to protect themselves from liability. It doesn't matter if you used marijuana medically over the weekend or socially the night before. If the result for THC is positive there will be consequences. Social workers will need to utilize a cost benefit analysis if they choose to use THC. Is it worth the cost? Only each individual can answer this until THC is legalized federally. Check the rules at your organization to be fully educated on the consequences. 

Self check ideas when using medically or socially:

1. Educate yourself on the pharmacological differences of THC, CBD, and marijuana strains.

2. Educate yourself on the physical, psychological, and mental effects of marijuana.

3. Use your knowledge of research to study yourself on the drug. How much has what effect? What do you notice as changes to your cognition (but remember, this study is biased!)What are other changes you notice? Have someone (not using) test your mental, physical and psychological acuity every half hour and write down the results.

4. Remember, as with any substance, you may have an inflated sense of being competent while using, when you actually are not.   

5. Do you have a back up plan in case a client reaches out to you in an emergency? 

Valid reasons exist to use THC; stress reduction, anti-anxiety, pain reduction, or recreation. The is not a post about the issues with addiction or using marijuana. Research and anecdotal evidence support significant relief of certain medical and psychological conditions.  This information is to remind us about being educated and mindful when we use any mind altering substance. Eliminate interactions using technology both professionally and personally during this time. Do not engage with clients or social media. No client wants should receive a text meant for someone else nor do you want your claim to fame to be "the Twitter Donald Trump of social work". The Internet's long memory is not one you want to become a part of in a negative way. Setting up standards for yourself if you choose to partake in any substance reduces risk for yourself and the populations you serve.

White Responsibility in the Current Culture of Hate

Why on Earth would I want an iWatch?

     More than a decade ago I left my wristwatch behind while I learned to access time on my cell phone. I never looked back. Not being bound to my watch offered a relief from a time bound schedule, or so I thought. As the abilities of the cell phone transitioned into a smart phone, time once again became an ever present reminder. Wearable tech became popular with step tracking to then exercise monitors. Looking at my Fitbit offered incentive and reward for walking plus a time keeper. Once again I had a watch. When smart watches appeared on the tech market it was the last device I thought I needed. My Fitbit functioned well, except when I washed it. After three waterlogged Fitbits' went by the wayside I decided a waterproof function would save me money. Enter the iWatch.

     I researched many options for waterproof, but since I swim laps this seemed the best and least expensive option for under $300 and even at this price it is expensive. I took the plunge not looking back since. Besides the swim feature, which I love, I can shower, wash dishes, and submerge my iWatch without consequence. Since I am forgetful, this feature alone proved a worthy purchase. The other features, which I am still exploring, decrease stress, improve my health and offer me options to improve my life I never thought I needed. This is a list of the features I adore (until I find new ones).

1. Find my iPhone - A little phone button on the swipe up screen offers a loud signal to find my phone when I set it down somewhere and I cannot remember where. This feature alone saves me hours (and being late) wandering the house trying to find my phone. While simple, the feature alleviates a lot of stress for the absentminded professor (me).

2. Heart rate monitor - Two words: Thyroid issues. The heart rate monitor identifies high and low rates, even when sleeping. When the heart rate averages start to climb or drop over time I know it is a signal for a thyroid check. Oh, and it is good for exercise.

3. Sleep monitor - I became hooked to monitoring my sleep with my Fitbit. The iWatch brought this to a new level. Being a researcher, I love graphs of all kinds. The sleep tracking option helped me come to terms with my insomnia and accept it as normal for me.

4. Standland - I sit, a lot. Between counseling, writing, and teaching online I am always at my desk. I even own a standing desk, which would work better if I remembered to use it. This app reminds me to stand at 50 minutes to the hour between whatever times I choose. An added benefit is the reward of  earning features within the game encouraging my agreement to stand.

Standland App - iPhone

5. Maps - This unexpected feature provided me with a gleeful surprise. If I put the address I want into the phone, before each turn my watch's hepatic system (little vibrations on my wrist) alerts me I will be needing to turn. If you talk through your car phone system, listen to books/podcast or tend to be problem solving while driving this feature saves a lot of time with the recalculating GPS when you miss your turn. Needless to say, this app saves me enormous amounts of time.

6. Mindful and Calm Apps - These two apps provide hepatic reminders to be in the present and breathe. These tools enhance my mindfulness practices and lower my stress levels. 

     These apps represent only a few ways the iWatch enhances my life. For me the purchase creates new habits and reinforces positive behaviors. If you have one, how does it help you?

Technology Integration for Social Care Education and Practice in the European Union

The European Social Network (ESN) invited me to speak at their Workforce Seminar in November of last year in Bratslavia, Slovakia. Alfonso Lara Montero is the Policy Director at ESN. Alfonso leads the organization to provide a collaboration to network countries in addressing the needs of their citizens through united education, research, action, and conferences. The event offered inspiration from speakers across Europe. You can hear their presentations here. The participants and presenters offered their experience to problem solve today's issues around social care. I am inspired by their commitment and ability to think outside of the box for solutions. As their mission describes...

"ESN is a network of over 120 member organisations in 35 countries which comprise national associations of directors, departments of social welfare of government, regions, counties and municipalities, funding and regulatory agencies, universities and other research and development organisations.

We believe that social services must protect and support vulnerable people, uphold their dignity and independence, pursue excellence and innovation in social work, listen to service users and respond to their needs, and promote solidarity with people and their communities."

Below is a podcast of the presentation.

Ellen Belluomini speaking at the ESN Workforce Conference

Technology Integration in Social Care Education and Practice in the European Union

Chapter 13 Technology Considerations in Running a Private Practice

Chapter Introduction

"Technology can offer challenges and opportunities for the private practitioner. This chapter first explores how psychotherapists of different ages experience boundaries and the Internet. The discussion progresses to methods of integrating technology assessment and digital testing and the impact of technology on the management of a private practice. Digital options per se are not unethical or inappropriate. Each area is viewed through a risk management and strengths lens. The intent is to guide the psychotherapist through potential complication of digital options while emphasizing the ways in which technology can ease the management of a private practice."

 

Google Books Link

 

I wrote this chapter to help clinicians adapt the technical challenges of practicing psychotherapy in today's rapidly changing world. This book is available on Google Books and Amazon.

Election Results : A Crisis or an Opportunity?

We do not need President-elect Trump to build a wall, we have already built one between us. It seems the more outrageous the story the farther its reach on social media. Americans are polarized now more than ever. People cannot keep up with the social advances a staggering rate of change in technological advances offers. Our social/emotional conditioning has not progressed to fully understand the implications of social media on relationships, the economy, and health, let alone the political arena.
 
Listening to the results of the election funnel through across America profoundly impacted each side of the political process. Nothing could prepare us for these shocking results. Despair and futility surface after the shock has worn off for some, while others celebrate change. How do we move through this time without creating enemies of our neighbors, coworkers, friends, and family?

Pew Research reported 44% of Americans get their news from Facebook. When analyzed, 38% of Republican and 19% of Democratic news feeds are reporting misleading or out right false news. This reporting helped to shape the outcome of this election. False news, like it or not, is shaping our country.

Reformation is the outcome of crisis in our midst. I offer an opportunity to be constructive in an atmosphere set up to be destructive. This may very well be a critical turning point in American history. No matter who you support, which side do you stand on...will you reconstruct the country in a positive or negative frame?

Steps to make our country great again using technology and our critical thinking in social media:


1. Keep your feed balanced with both Democratic and Republican friends. 

I know, this is a difficult ask. The reason for this is to understand what information the other side is being fed in their data streams. If your feed only supports your ideology, both sides are in danger of taking the blue pill of ignorance.

2. Detect and alert about false news.

Phony news falls into three categories, click-bate, satire, and fake. Click-bate has a morsel of truth, but then adds outrageous information so you will click on it and make them money. Fake sites are similar except they offer completely false headlines tailored to draw you into believing and forwarding the information to, once again, make more money. These two sites market to the gullible, don't be gullible! Start thinking of clicking as income. Where do you want to focus your money?  If we stop forwarding these sites then their income will cease. Satire sites make fun of real issues, but some may take it seriously. Reading someones comments to these sites will alert you to if the joke is understood or their is belief in the story.

Visit this site, Fake News Sites,  monthly and print it out or place it in a document you can refer to while reading social media. If you find a feed on your friends social media account, don't click on it but put a picture in the comments.

If you know the information to be inaccurate from the picture you can offer Snopes.com or any evidence based site (.edu or .gov) as a fact checker. Well known news sites are trickier to identify. We would all like to believe that the New York Times or Fox News is always accurate. Look up their statistics on delivering accurate news. Some news programs or newspapers have a high falsehood rate. Learn to discern the difference.


3. Engage in critical thinking about news feeds. 

Ask yourself these questions...

     a. Does it sound too good to be true?
     b. Are you reading the article from an all good or all bad
         viewpoint?
     c. What is the source? Do they support their statistics from valid data?
     d. Could my bias about this information support the claim?
     e. Is the language of the information inflammatory to a group of people (ethnic background,
         income level, sexual orientation, disability, gender, etc.)
     f. What do the qualified experts/scientists say?
     g. Is there video directly from the person which supports the claim?
     h. If you want to believe the claim regardless of what the experts say, why?

Truth starts with a question. Asking questions is the foundation of our democratic system. If you are challenged on a topic, rejoice! Not only does asking questions offer more knowledge, it increases our embrace of the democratic process. When we stop asking questions and blatantly accept all the information given to us we become a nation headed toward communism. Remember, Communists are not allowed to ask questions...don't give up your rights fought for by countless human lives.Ask questions...lots of questions...







     

Apps in Social Work Practice Infographic