Substance Abuse Disorder Treatment - Case Study Example

Substance Abuse Disorder Case Analysis Name: Institution: Question 1 From the above case study, it is evidently clear that Harry is suffering from substance induced psychosis. The client’s condition meets the criteria of DSM IV TR for substance abuse disorder. According to Center for Substance Abuse, 2009, one qualifies to be diagnosed of substance abuse such as alcohol if one has history of maladaptive drinking pattern within a 12 month period that leads to functional and physiological impairment. The impairment is characterized by recurrent substance abuse which leads to failure in meeting one’s roles and obligations (A1), using these substances in physically hazardous situations A2), substance related problems(A3) and persistent substance abuse despite presence of social and interpersonal problems caused by substance abuse symptoms (A4) (Center for Substance Abuse, 2009). Therefore, the client in the case study meets the above classification of substance abuse because; the client has history of recurrent substance abuse which has led to poor performance at the work place, going to the workplace when late and has been threatened to be fired from the workplace due to his behavior. Additionally, the client has past history of prolonged alcohol abuse and cannabis abuse .Therefore he meets criteria A1. Furthermore, the client has history of recurrent interpersonal and social problems. This is evidenced by his break up with his girlfriend due to his behavior, fighting with the patron at the night club due to difference in their argument, and being argumentative at the time of admission. Therefore, he meets the characteristics define in criterion A4 of the DSM IV for substance abuse. Question2 According to Roxburgh et al. 2010, one in every three Australians report history of cannabis use at a period of their lifetime. This constitutes approximately 34% of the population. Males have high risk of using cannabis (37%) than females (30%). Approximately 18% of secondary school students have history of cannabis use. The prevalence of cannabis dependence in Australia is 1.5%. Daily use of cannabis is more prevalent in population aged 40-49 years. Population aged 14-19 years has the heaviest prevalence use. The hospitalization rate for cannabis closely correlates with the prevalence trends of its use. The average age of initiation to cannabis use is 19 years. Heavy abuse of cannabis predominates in the aboriginal communities (27%) as compared to the non-aboriginal communities (22%). (Roxburgh et al. 2010). Correia et al. 2012 identifies that one of the possible causes of increased cannabis use is its availability. One in every five Australians reported that they have easy and very easy access to and use of cannabis. There is high supply of cannabis to the Australian population than any other drug. This is evidenced by the cheap price associated with the naturally grown cannabis. Straussner, 2008 recognizes that cannabis abuse has multiple burdens both to the users and their families. Prolonged cannabis use causes substance induced psychosis that cause impairment in the ability to perform activities of the daily living. Additionally, cannabis abuse results to impairment of one’s cognitive functioning, abnormal reproductive functioning, and cardiovascular effects such as stroke and heart attack and cancer risks among other effects. The treatment required by cannabis abusers is expensive. This acts as a source of burden to the family since a lot of capital is required for managing and providing treatment to the affected individuals (Williams & Union, 2008). Question 3 One of the factors that might have contributed to Harry’s substance abuse is his family history of drug and substance abuse. From the case, Harry reports that his father liked drinking alcohol when Harry was at his early ages. Aronson, 2009 identifies that drug and substance addiction is more common in families with history of drug abuse. This increases the risk of substance abuse gene transfer to the siblings which predisposes them to substance and drug abuse at their lifetime. Therefore, there is a high chance that the client in the case study inherited drug and substance abuse genes from his father since he was a drug addict. Psychosocial factors such as poor parental upkeep among the population contribute to drug and substance abuse (First & Tasman, 2011). Harry states that he had poor relationship with his father that consequently led to them being abandoned by him. This could have led to poor parental upkeep hence, drug and substance abuse. Theories such as the behavioral theory state that individual’s behavior is socially acquired (Castle & Murray, 2008). Therefore, Harry’s drug and substance abuse could have been contributed by social factors. These factors include peer pressure, ease availability of cannabis in the society and societal attributes to the drug use such as source of energy and motivation contributing to drug and substance abuse. Stressors such as one’s daily experiences predispose one to drug and substance abuse (Allhoff et al. 2010). Harry could have been driven by various stressors such as past family experiences, breakup with his girlfriend and past history of juvenile detention to engage in drug abuse. Question 4 The patient in the above case study is experiencing series of multiple substance and mental health related problems. These problems are likely to impact negatively on the client’s health and his overall performance of the activities of the daily. Therefore, the client is experiencing mental health problems and risks which include being at a risk of developing depression, self-injury through committing suicide and developing alcohol dependence. The client is at a risk of developing depression. It is evidenced by his behavior of taking alcohol to suppress the past negative experiences such as breaking up with his girlfriend and his past poor relationship with his father. Harry has lost his job secondary to the outcomes of his prolonged alcohol and cannabis abuse. Furthermore, Harry has been spending most of his time calling his ex-girlfriend whenever he is intoxicated. This shows that he is lonely and feels neglected. Therefore, he is at a risk of developing depression secondary to the above factors. Harry is at a risk of committing suicide secondary to suicidal ideations and feeling of helplessness. Harry expresses that his life is out of control. This is because he has lost his job, broken up with his girlfriend and has no one to depend on due to his past experiences. Additionally, Harry is at a risk of developing alcohol dependence. He drinks 2-3 Bundaberg rums per day and has been abusing alcohol since he was 16 years old. The patient has increased his drug and alcohol use in the past six weeks. Therefore, the patient is at a risk of developing alcohol dependence in order to maintain his normal urge of drug and substance use. Other mental and health related problems that the patient is at a risk include imbalanced body nutrition, activity intolerance, risk of drug non-compliance and risk of absconding from the hospital among other substance abuse related risks. Question 5 and 6 Mental problem/risk Nursing Intervention Scientific Rationale Self-injury through committing suicide. 1. Monitoring carefully the patient for any suicidal attempts or behaviors evidenced by the patient’s interaction with the other patients, verbalization and any other suicidal attempt signs (Babor, 2010). 2. Keep any equipment/items that can be used by the patient to inflict self-injury away from patient’s reach. 3. Seclude the patient in safe rooms free from any contributing factors that might aid patient in causing self-harm and harm to the others. 1. Monitoring the patient will enable the nurse identify any suicidal attempts by the patient and respond effectively. Ghodse, 2011 States that suicidal attempts can be controlled by administering antidepressants and moods stabilizers. 2. Keeping away dangerous items minimizes the patient’s suicidal attempts. This maintains the patient’s, other patients and healthcare team safety. 3. Secluding the patient will minimize his suicidal attempts and also maintain the safety of the other patients and that of the healthcare providers. Depression 1. Establish trusting relationship between the nurses and the client through introducing yourself to the client, interacting positively, listening carefully to the client’s problems, avoiding arguments and judging the patient’s behavior. 2. Administer the prescribed antidepressants. 3. Consider referring the patient to the psychiatrist. 1. Establishing trusting relationship enhances patient trust towards the healthcare provider, enables the nurse understands patient’s needs and improves patient’s self-esteem. 2. Antidepressants act by inhibiting the re-uptake of neurotransmitters including serotonin, and noradrenaline at the nerve endings hence, alleviating depression (Galanter & Kleber, 2008). 3. The psychiatrist will evaluate other management strategies such as use of psychotherapy to manage the patient. Alcohol dependence 1. Monitor patient’s alcohol consumption, frequency of intake, volume, severity of symptoms associated with the intake and assesses the effects of alcohol intake on the client’s ability to perform various activities of the daily living (Castle & Murray, 2008). 2. Encourage the patient engage himself in support group activities with other alcohol addicts. 3. Initiate follow up activities to evaluate patient’s adherence to management program and coping mechanisms aimed at minimizing effects of alcoholism. 1. Monitoring will enable the nurse understand the client’s alcohol intake rate and associated effects thereby coming up with the effective management plan. 2. Engaging in support groups will enable the patient acquire necessary knowledge required to overcome alcohol dependence and also help him understand effects of alcoholism hence, stopping alcohol abuse (Williams & Union, 2008). 3. Follow up acts as a sense of appreciation to the client and also an opportunity for the nurse to evaluate client’s progress. It also provides opportunity for sharing health messages. References Aronson, J. K. (2009). Meyler's side effects of herbal medicines. Amsterdam: Elsevier. Allhoff, F., Jacquette, D., & Cusick, R. (2010). Cannabis - Philosophy for Everyone: What Were We Just Talking About?. Chichester: John Wiley & Sons. Babor, T. (2010). Drug policy and the public good. Oxford: Oxford University Press Castle, D. J., & Murray, R. (2008). Marijuana and madness: Psychiatry and neurobiology. Cambridge, UK: Cambridge University Press. Center for Substance Abuse Treatment. (2009). Clinical guidelines for the use of Buprenorphine in treatment of opioid addiction. Rockville: SAHSA. Correia, C. J., Murphy, J. G., & Barnett, N. P. (2012). College student alcohol abuse: A guide to assessment, intervention, and prevention. Hoboken, N.J: John Wiley & Sons. First, M. B., & Tasman, A. (2011). Clinical Guide to the Diagnosis and Treatment of Mental Disorders. Hoboken: John Wiley & Sons. Galanter, M., & Kleber, H. D. (2008). The American Psychiatric Publishing textbook of substance abuse treatment. Washington, DC: American Psychiatric Pub Ghodse, H. (2011). Substance abuse disorders: Evidence and experience. Oxford: Wiley- Blackwell. Roxburgh A, Hall WD, Degenhardt L, McLaren J, Black E, Copeland J, & Mattick R. P. (2010). The epidemiology of cannabis use and cannabis-related harm in Australia 1993-2007). Journal of Medical Sciences. Vol. 105(6), p. 1071-1079. doi: 10.1111/j.1360- 0443.2010.02903.x. Epub 2010 Mar 12. Straussner, S. L. A. (2008). Ethnocultural factors in substance abuse treatment. New York: Guilford Press. Williams, C., & Union Institute & University. (2008). Cultural pain and anger as causal factors to substance-abuse in an African-American male clinical population: An exploration with implications for treatment. New York: Sage. Read More