|Essay type:||Problem solution essays|
|Categories:||Medicine Mental disorder Substance abuse|
Section 1: Synthesize Assessment Findings
Criteria one for psychoactive substance use disorder depicts the presence of suspensions from school, poor work performances, and failure to meet or fulfill major role obligations at home, school, or work (Hasin et al., 2013). Logan meets this criterion because he was expelled from school in grade 7 and was expelled from work for his lateness in reporting to work. Even after getting a job in the army, he dropped it because of drinking too much behavior that made him unfit for the job. He was employed as a sniper but dropped following the lieutenant's claim that he was too excited. He also possessed anger issues while in the army because it was hard to see his friends being blown out and dye.
The second criterion for psychoactive substance use disorder is the continued use of a drug despite the knowledge of having persistent interpersonal problems made worse by the effects of the substance (Shivani et al., 2002). Logan has continued to use alcohol despite being aware of recurrent social and physical problem of divorce that was made worse by drinking too much alcohol. Logan has previously had to divorce, and both are attributed to alcohol use. He alluded to having lost his temper or gotten into arguments or fights while drinking alcohol. As a result of substance use, Logan had fights with his wife, and this made her furious and decided to leave him because of the impending danger of staying with him. In his second marriage, the wife left him and went with the only child they had together. The family battles have made him go to court to be granted permission to see his child.
The third criterion is that Mr. Logan depicted recurrent substance-related legal problems evidenced by several arrests for various offenses such as fighting with his ex-wife. During one of the arrests, he was found in possession of a bear in his house. These legal issues that Mr. Logan had with legal authorities justify the criterion for substance use disorder dependence.
Following the criteria for psychoactive substance dependence, Mr. Logan meets three conditions. First, Mr. Logan responded to have never tried to cut down or quit drinking. However, this appears contradictory to the findings that he went to seek help because of his drinking too much. This shows evidence of withdrawal from using alcohol, although unsuccessful. Logan admitted having a feeling of drinking too much alcohol. As a result of excessive drinking, he has previously experienced blackouts and memory loss (Koch et al., 2002). There is additional evidence of withdrawal suggesting that Logan tried stopped drinking, although it was not successful. Logan responded in the affirmative when asked whether he felt sick, shaky, or depressed when he stopped drinking. Although he previously denied stopping taking alcohol, the response implies that he has never tried to withdraw, and that is why the feeling of sickness and shakiness came about.
Secondly, Mr. Logan drinks alcohol for an extended period to get rid of the stress associated with the lack of a job that he highly needs. Although Mr. Logan feels good about himself, he needs a job, and this makes him unhappy. Losing a series of jobs and two wives, in addition to having no money even to buy the medication, is a stressful affair for Mr. Logan. Thus, the surrounding issues he faces can be the contributing factors to his recurrent use of alcohol and unsuccessful attempt to withdraw.
Thirdly, Mr. Logan has shown a recurrent physical problem where he uses alcohol despite having lost two wives in his marriage. Having heard complaints from the first wife about excessive drinking, he ought to have mended his life and engage with the second wife in a sober mood. However, even after their second wife left him for the same reason, he appears to continue abusing alcohol. He is also aware that his parents divorced due to excessive use of alcohol and continues to use alcohol with full awareness.
According to the American Psychiatric Association (2013), the client, Logan, has a physiological dependence since there is evidence of withdrawal from taking excessive alcohol. There is, however, no evidence of tolerance, but withdrawal is enough to classify the disorder as being with physiological dependence. Based on the analysis, Logan met the criteria of psychoactive substance dependence for alcohol and with physiological dependence evidenced by tolerance and withdrawal from its use.
Section 2: Referral Recommendations: Multidisciplinary Team Approach
Mr. Logan has been engaged in excessive alcohol use, and the interview results reveal that the drug has ruined his marriage, family life, communication skills, career, and social life. He is ride when responding to questions and appears to care less about his life. Mr. Logan only wants to see his child.
A psychoactive substance use disorder can be addressed in several ways, but the most appropriate and suitable way is to use a multidisciplinary team approach. A multidisciplinary team approach is comprised of several professionals or organizations that enhance the treatment for an individual with psychoactive substance use disorder. Although every person performs a specific role and responsibility differently from the partner, the collaborative effort yields positive results beneficial to the client. The multidisciplinary team will intend to enhance the treatment for Logan
The multidisciplinary team will be composed of:
- Primary care physician/ Nurse practitioner/ Physician’s assistant
- Addiction Psychiatrist
- Social worker
- Alcohol counselor
Each of the professionals is expected to a contribute towards improving the treatment plan of Mr. Logan. A primary care physician (Doctor of Osteopathic Medicine) will evaluate to establish whether the drinking pattern of Mr. Logan is risky or not. The riskiness of the drinking pattern will aid in determining how to design a treatment plan. The physician will then craft the treatment plan and use it to reduce the usage of alcohol. In addition to the treatment plan, the primary care physician evaluates the overall health of Mr. Logan to unravel the underlying issues that might have been contributed by the excessive use of alcohol and further see how they can be addressed. With the proper information about Mr. Logan, the physician can assess the appropriateness of the medications used in the treatment of substance use disorder.
Both the alcoholic counselor and a psychologist are involved in the behavioral treatment of a patient suffering from substance use disorder. The two are essential in the multidisciplinary team for the immense contributions in aiding in understanding the problem underlying alcohol use. The alcoholic counselor also offers support for recovery from the affected psychological aspects associated with alcohol use. The alcohol counselor will take Mr. Logan through the recovery journey until an alcohol-free life is attained. An alcohol counselor is very useful in ensuring recovery since he ensures that the patient adheres to the treatment plan.
An addiction psychiatrist contributes to Mr. Logan's recovery by performing evaluations, diagnosis, and treatment (Well et al., 2013). The psychiatrist helps on how to deal with issues affecting Mr. Logan, such as family life and the problem with his wife. As part of the multidisciplinary team, the psychiatrist collaborates with the primary care physician in designing a treatment plan and how the medications and therapy will be used. The social workers collaborate with other professionals in the multidisciplinary team to increase their skills on how to serve the population majorly affected by the social issues in the setting. The social workers ensure that the evidence-based approach is used and is relevant to the policy, and culture specific to Mr. Logan.
Section 3: Confidentiality
According to the American Psychological Association (2013), maintaining the information about Mr. Logan requires that consent be ensured. Hence, when dealing with Mr. Logan, the multidisciplinary team must communicate and inform him of the information that will be shared with the court and which will not be shared. He must be guaranteed privacy. Besides, each of the professionals in the multidisciplinary team must agree to keep the information private and confidential unless with the client’s consent.
In this regard, the information about the client should not be disseminated without the client's consent. Besides, in the situations where dissemination is agreed upon, the team professionals should only share with the involved parties only without the inclusion of a third party. These are some of the guidelines that are also inherent in each professional's code of ethics and should be applied when dealing with the patient.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Publishing
Hasin, D. S., O'Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W. M., Crowley, T., Ling, W., Petry, N. M., Schuckit, M., & Grant, B. F. (2013). DSM-5 criteria for substance use disorders: recommendations and rationale. The American journal of psychiatry, 170(8), 834–851. https://doi.org/10.1176/appi.ajp.2013.12060782
Koch, D. S., Nelipovich, M., & Sneed, Z. (2002). Alcohol and other drug abuse as coexisting disabilities: Considerations for counselors serving individuals who are blind or visually impaired. RE: view, 33(4), 151.
Shivani, R., Goldsmith, J., & Anthenelli, R. (2002). Alcoholism and Psychiatric Disorders. Alcohol Research & Health, 26(2), 90-98. Retrieved 16 May 2020, from https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm.
Wells, E. A., Kristman-Valente, A. N., Peavy, K. M., & Jackson, T. R. (2013). Social workers and the delivery of evidence-based psychosocial treatments for substance use disorders. Social work in public health, 28(3-4), 279–301. https://doi.org/10.1080/19371918.2013.759033
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