Substance Dependence and Substance Abuse - Assignment Example

Question 1 The two terms used to describe substance abuse disorder include substance dependence and substance abuse (NHMRC, 2011). Substance dependence is also known as drug addiction. It is the state where an individual feels a strong urge to use drugs in order to function normally (NHMRC, 2011). The absence of drugs leads to withdrawal symptoms (NHMRC, 2011).Substance abuse or drug abuse is the state where an individual uses drugs in a patterned and unsupervised way (APA, 2011). The individual consumes drugs in large and uncontrollable amounts (APA, 2011). Alcohol is one of the most abused substances by many people. Based on the DSM-IV-TR criteria for Substance Abuse Disorder, alcohol abuse is manifested by several symptoms which include; persistent alcohol use which lead to poor performances at work and at home; absences from work; expulsions or suspensions from work; legal problems that are alcohol related (this include arrests for disorderly conduct); and interpersonal or social problems with friends and spouses (arguments between friends or spouse on consequences of alcohol abuse) (APA, 2011). From the above list of symptoms of alcohol abuse, Harry may meet the criteria for substance abuse disorder because he depicts some of the above symptoms. They include; argument with his girlfriend about the consequences of alcohol uses; getting to work late; warnings of being fired from the workplace, neglect of his social duties that led his girlfriend to live him; and arrest by police at the nightclub for disorderly conduct. All these are indications that Harry meets the criteria for a Substance Abuse Disorder. Question 2 According to a report released by the Australian Institute of Health and Welfare (AIHW), more than 200,000 Australians smoke Cannabis daily (AIHW, 2008). It is also reported that more than 5.8 million Australians or 33.5% of the total Australian population aged 22 and above uses cannabis in their daily lives (AIHW, 2008).This makes Australia one of the countries with the highest prevalence rates of cannabis use in the world. Among the ethnic groups, the indigenous population leads in the prevalence of cannabis use in Australia. Among the Aboriginal and Torres Strait Islanders, it is estimated that approximately 50% have used cannabis in their lifetime and continue to use this drug even today (AIHW, 2008). In addition, it has been reported that the incidence rate of cannabis use is higher among the police offenders and detainees. The use of cannabis in Australia is associated with structural and social determinants of drug abuse (NHMRC, 2011). They include lack of social, educational and occupational opportunities, poor relationships in the families and issues related to mental health (NHMRC, 2011). It has also been reported that societal and environmental factors interact with other risk factors to increase the prevalence rate of cannabis use among the Australians (NHMRC, 2011). For instance, cognitive problems and poor parenting styles are some of the possible causes of the high prevalence rate of cannabis use among the Australian population (AIHW, 2008). Additionally, the rate of cannabis is higher among the indigenous population due to poor socio-economic status of Aboriginal and Torres Strait Islander. Moreover, the National Health and Medical Research Council (NHMRC) reported that other possible causes of cannabis use include peer influence; relaxation, pleasure, and habit development that make the users crave for the drug on a daily basis (NHMRC, 2011). From the national hospital morbidity data released by the National Drug and Alcohol Research Centre (2010) hospital admissions related to cannabis use have increased dramatically in the recent years (National Drug and Alcohol Research Centre, 2010). More than 2500 hospital admissions were registered between 2008 and 2009. However, hospital admissions related to cannabis represent 4% to 10% of the total drug-use hospital admissions. The greatest percentage of hospital admissions is from the indigenous population. Cannabis is associated with different types of disease burden. Among the common cannabis-related harms that lead to hospitalization include; sputum production, chronic cough, bronchitis and wheezing, and myocardial infarction (National Drug and Alcohol Research Centre, 2010). Question 3 Several factors are associated with an individual’s development of substance use disorder. These factors can be grouped under three main categories which include; biological, psychological, and environmental factors (Nutt, King, Saulsbury & Blakemore, 2008). The biological factors include genetic predisposition which is better explained under family history as well as craving and withdrawal effects (Nutt, King, Saulsbury & Blakemore, 2008). Psychological factors include early initiation, childhood trauma or loss, lack of interest in conventional goals, poor capability stress management, and escape from reality (Nutt, King, Saulsbury & Blakemore, 2008). Environmental factors include environmental stressors such as marital problems (Bogdanoski, 2009). The two possible factors behind the development of Harry’s substance use disorder include biological factors and psychological factors and the main biological factors include genetic predisposition. From the case study, Harry’s father was alcoholic and Harry might have inherited the same genes from his father. According to Johnson (2011) it is highly possible for an individual to inherit alcoholism tendencies and the risk increases in individuals whose parents used to consume alcohol. The main psychological factors behind Harry’s development of substance use disorder are early initiation and poor relationship with his father. Based on psychodynamics theories formulated by Freud, Seize & Mueller (2012) noted that an individual’s tendency to substance abuse can be traced to his/her early age. This is because poor relationships between parents and children increase the vulnerability of an individual to substance use. This is evident in the case study because Harry had a poor relationship with his father who left him and his mother when Harry was only 14 years old. In the same perspective, Harry was initiated to alcoholism when he was also young, at 16 years. Early initiation to substance use is a major factor that contributes to substance abuse later in life (Seize & Mueller, 2012). Hence, biological and psychological factors can better explain the Harry’s development of substance use disorder. Question 4 The three major substance and mental health related problems in Harry’s case include depression, alcohol dependence and extreme feelings of irritability. Alcohol is known to affect an individual’s central nervous system leading to a depressed system that is not likely to withstand pressures caused by life stressors such as marital problems (National Drug and Alcohol Research Centre, 2010). It is evident that Harry experiences the problem of depression due to excessive stress caused by the problems he has with his girlfriend who has left him. In order to cope with this stress, Harry is likely to continue consuming more alcohol so as to escape from his painful reality. This explains Harry’s alcohol dependence problem. Harry states that being stoned and smashed helps “him to forget”. This means that Harry has reached the stage of alcohol dependence which helps him feel relaxed and escape from painful realities of life when he consumes alcohol. The problem is that Harry may feel worse when the effects of alcohol in his bloodstream are over (National Drug and Alcohol Research Centre, 2010). He may end up feeling stressed more which may push him to consume more alcohol. Extreme feeling of irritability is a mental health problem that Harry experiences (National Drug and Alcohol Research Centre, 2010). From the case study, Harry presented as irritable, argumentative on initial assessment. This is the cause of Harry’s involvement in a fight and argument with a patron in the nightclub. According to Elder, Evans & Niszette (2009), extreme feeling of irritability is a sign of mania in bipolar disorder which shows that an individual’s mental health is affected by the substance use (Elder, Evans & Niszette, 2009). Question 5 & 6 Problems Interventions Rationales 1.Depression 1. Take Harry through a training program to offer encouragement to him that he can recover from the substance use disorder (American Psychiatric Association (APA), 2011). 2. Establish a positive relationship with Harry that is based on empathy rather than sympathy. In addition, establish a good relationship based on mutual trust. 3. Help Harry develop his own recovery goal by taking him through some of the steps he may feel comfortable to undertake towards recovery 1. The first step towards recovery is to give the patient encouragement, motivation and hope that depression is treatable and his depression problem will come to an end (Robin, 2013). 2. A patient feels comfortable to share confidential information with a person that seems to feel the way the patient feels. Hence, empathy and trust should be exercised in order to obtain the required confidential information from the patient. 3. Allowing a patient to participate in his own recovery plan makes him feel empowered and appreciated. He is not likely to forget the recovery plan he develops himself. 2. Alcohol dependence 1. Begin by recording the frequency, time, and likely situations that trigger alcohol consumption (NHMRC, 2011). 2. Help the patient to think and discuss about the role of alcohol in his life. This should be confidential to allow the patient to provide all the required details (NHMRC, 2011). 3. Provide suitable behavioral treatment approaches such as support group or therapy 1.To establish a treatment plan 2. The objective is to allow the patient to develop his own conclusions about advantages and disadvantages of alcohol (NHMRC, 2011). 3. To take the patient through the treatment process 3. Extreme feelings of irritability 1. Help the patient develop the tendencies of sleeping enough 2. Help Harry develop the tendency of regular exercises such as running in the morning and evening 3. Take the patient through relaxation techniques such as muscle relaxation, and meditation 1. To enable the patient to relax his mind to avoid exacerbating anxiety or stress (Nutt, King Saulsbury & Blakemore, 2008). 2. To help the patient to improve his outlook and mood, relive anxiety and bust stress (Nutt, King Saulsbury & Blakemore, 2008). 3. To enable the patient to develop tendency of thinking about the negative and positive aspects of his behavior. References American Psychiatric Association (APA) (2011). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC: APA. Bogdanoski, T. (2009). "A dose of human rights: an antidote to the criminal prohibition of cannabis for medical use?". Crim LJ 33 (5): 251–62. Elder, R., Evans, K., & Niszette, D. (2009). Psychiatric and mental health nursing ( 2nd ed.). chatswood, N.S.W: Elsevier Australia. Johnson, B. (2011). Psychoanalytical treatment of psychological addiction to alcohol (alcohol abuse). Frontiers in psychology, 2(362), 1-10. National Drug and Alcohol Research Centre (NDARC) (2010). National Hospital Morbidity Data. Hospital admission related to cannabis use. http://ndarc.med.unsw.edu.au/news/big-jump-hospital-presentations-and-admissions-cannabis-problems National Health and Medical Research Council (NHMRC) (2011). Alcohol and health in Australia. Accessed via http://www.nhmrc.gov.au Nutt, D., King, L.; & Saulsbury, W., Blakemore, C. (2008). "Development of a rational scale to assess the harm of drugs of potential misuse". The Lancet 369 (9566): 1047–1053. Robin, R. (2013). Could a regulated cannabis market help curb Australia’s drinking problem? The Conversation Australia. Retrieved 18 July 2013 Seitz, H., & Mueller, S. (2012). Alcohol and Cancer. Drug Abuse and Addiction in Medical illness: Causes, Consequences and Treatment, 3 (1), 431-441. The Australian Institute of Health and Welfare (AIHW)(2008), 2007 National Drug Strategy Household Survey. First results. Canberra: Australian Institute of Health & Welfare. Read More