Substances abused and implications of abuse
Substance abuse and drug addiction have been a running debate as many young people get used to drugs. Drug abuse victims today have filled healthcare centers and emergency departments because of health damages caused by drug use. The most commonly abused drugs include alcohol, tobacco, cocaine, marijuana, and heroin. According to McKetin, McLaren ,Lubman & Hides (2006), the use of cocaine, heroin and marijuana causes the most adverse effects on victims of drug and substance abuse. James Adams is a now a 20 years old man who has been addicted to cocaine. He is half-American half-Asian and has been using the drugs frequently for the last two years since he was 18, and it has become hard for him to leave these drugs.
According to the National Institute of Drug Abuse (2013), cocaine has an estimate of 2.5 million users in United States. Excessive use of cocaine causes serious effects in the brain. The drug stimulates the nervous system increasing the levels of the neurotransmitter dopamine in the brain that regulates movements and pleasure. Long-term continuous use of cocaine causes changes in brain functioning system that leads to addiction. If not early treated, the drug use could course risky psychological and physiological effects. Adams has developed full addiction to the drug and increased the daily dose in order to maintain his pleasure. Other implications of cocaine abuse include contraction of blood vessels, increased heart rate, high body temperatures, and high blood pressure. In addition, Adams is always complaining of headache, abdominal pain and nausea. Moreover, his appetite has reduced making him lose more weight. Adam’s cocaine use has seriously affected his physical health. He explained to the treatment experts that he has experienced many physical ailments resulting from cocaine use.
Biological predispositions
Scientists argue that drug addiction is predisposed by genes, but the reality is addictive behavior is biologically predisposed. Even if being addicted to drugs might not be genetic, some genetic factors play a role in addictive process. Evidence also shows that 50% of people who abuse drugs do so through genetic predisposing (Kalivas, 2003). Adams father used drugs such as cocaine, alcohol and marijuana that could have transferred genes to his son. Adams is a half cast between an African American and an Asian. Statistics show that most of African Americans living in United States are addicted to drugs in one way or another. On the other hand, patterns of substance abuse are more common among minority groups, whereby African American race is a minority in US. In addition, Adams has Asian genes that also contributed to his addictive behavior. The fact that Adams comes from one of the minority groups in US could have contributed to his cocaine addiction. Adams parental genes could have played a significant role on his addictive behavior. Many genes determine the character of an individual including skin color, hair and eye color, personality and cognitive behaviors (National Institute on Alcohol Abuse and Alcoholism, 2002). Family considerations
In order to design an effective Substance Abuse Assessment and Intervention Plan for Adams, his family must be included. Family interventions on drug abuse assessment assists in determining more information about his addiction. Substance abuse intervention programs using the family of the victim make use of family interventions. Psycho education and multifamily groups will take part in the treatment plan. The process will involve confronting members of Adams’ family and friends by conveying to them the impact of substance abuse and the immediate urge for treatment. Family consideration will focus more on family therapy encourages intra-family relationships while the treatment experts consider on assisting client abstain (Straussner & Fewell, 2006).
On the other hand, the family of the victim must be involved for identity purposes. The victim immediate family members must be aware of all activities taking place in the rehabilitation center. Moreover, the victim’s parents or guardians should be present at the start of treatment to provide information about the person including his eating habits, how often he has been using the drugs, relationship with other people, and any other unique character discovered from the patient (SAAS Update, 2007). Some of the relevant information required from the family members include:
- Drug use
- Mode of use (e.g. smoking, inhaling or injecting).
- Quantity used
- Frequency of use
- Patterns of use.
In addition, the family history of the victim plays a vital role in designing the assessment and treatment plan. Some of the family information needed include:
- Parents marital status
- Legal status (whether they are citizens or immigrants)
- Alcohol use by parents
- Domestic violence history
- Education level
- The financial status of parents
Cultural considerations
Adams is half African American and half Asian who seems to be more connected with culture. The victim involves himself with cultural groups and enjoys sharing same beliefs and ideas. While designing a substance abuse treatment plan, the culture of the victim must be considered. The United State federal and state government have introduced cultural competence services in many care settings including substance abuse and mental health disorders. These settings allow people from different cultures access to effective treatment services depending on their cultural backgrounds. In addition, the government provides a wide range of recommendations that enable rehabilitation centers to offer quality treatments to victims. Ethnic sensitivity is an essential factor that influences the type and method of treatment to give to people from certain communities. According to Finn (1994), individuals from minority communities require particular consideration while designing their substance abuse treatment plan. In addition, cultural responsiveness assists in recognizing the patient’s identity, and overcoming cultural barriers that hinder the treatment plan. The following four techniques will be used in designing Adams’ treatment plan:
- Avoiding assumptions
- Trust building towards the victim, his family and friends,
- Identification of key cultural issues making the victim more addicted, and
- Making the counseling process private and confidential
Therapy model
This treatment plan will use Bayside 6 phase therapy model. This model has been voted as the most influential for victims of substance and drug abuse. In addition, the model has been tested, and approved by the National Institute of Drug Abuse to be the most effective in rehabilitating drug users. Working in phases helps in improving awareness, motivation, insight and victim preparedness together with the provision of tools necessary for maintaining long-term recovery (Duncan, 2011; 15-16).
Assessment and diagnosis
Assessment and intervention will be carried out using a self-administered interview to the client. The answers provided by the client will assist in making rational judgments and decision on how to implement the treatment plan. In addition, a problem prioritizing scale will be used to determine the level and potential of addiction before embarking on any treatment plan (Maville & Huerta, 2008). Intervention criteria will test for the following four features;
- The ability of the victim to fulfill main obligations at school, work, or home
- Recurrent of substance related legal problems,
- Any physical dangers caused by the client, and
- Continued use of drugs despite the use of recommended therapy model
Treatment plan and intervention strategies
Adams treatment plan will follow the six phases described in the bayside model.
Phase one: incentive
The main objective of this phase is to assist Adam ability to stay clean and sober. During this phase, Adams will be taken through a series of exercises and treatment plans aimed at motivating him to become clean and sober. During this phase, the client will be passed through his history of drug use, consequences of drug abuse and other factors that create a desire to use the drug.
Phase two: awareness
This phase helps create an insight on self awareness and the nature of addiction. The patient will be taught a variety of topics related to drug abuse, treatment processes, and recovery procedures. Adams will be trained on techniques he can use to treat himself in the absence of a physician.
Phase three: Support
On this stage, the patient will be provided with all the necessary support needed to enable him stay away from the drug. In addition, the family members will be encouraged to provide full support to the patient and provide feedback on his progress. This stage also assists in identifying the strengths and weaknesses of the victim. Adams will be required to identify specific people, organizations, therapists, and support groups to act as primary supports.
Phase four: Vigilance
This phase aims at determining factors that might hinder the client from using the drug and create a solid prevention plan. Adams will be required to identify specific people, places and materials that make him more susceptible to cocaine use. The patient will then undergo a series of exercises aimed at creating a gap from the above named factors. A person who successfully passes through this phase becomes more aware about ways to achieve full recovery. When Adams passes this stage, he will be in discharged from the rehabilitation center and the remaining programs will be conducted from home.
Phase five: preparation
The main aim of stage five is to develop a solid discharge plan capable of addressing all the client’s issues and give the most appropriate method of continued recovery. During this level, Adams will be given a three-month plan outlining daily recovery activities.
Phase six: accountability
During the final phase, the client will be provided with more support, and the rehabilitating team will be accountable for all his activities for the coming three years. According to Drug abuse and addiction media guide (2001), the first three years are the most challenging in addiction recovery. Patients have an easy time staying away from drugs while in a rehab but when they are discharged the addiction starts again. It is for this reason that the treatment team will continue monitoring Adams’ recovery process for the coming three years. This continuing care requires the patient to visit the treatment center three months after discharge. Ethical and legal considerations
The treatment team must consider ethical and legal issues associated with drug abuse treatment plan. In order to ensure the legerity and acceptability of the treatment plan, these steps were followed.
- The team will define the problem intellectually and emotionally
- ASCA and ACA ethical codes will be applied together with legal issues
- Consideration of individual rights, parental rights and cultural rights,
- Determination of the potential course of action and its consequences
- Application of moral principles
- Consulting with the government, and
- Implementation
In addition, the following ethical and legal issues were considered, informed consent and confidentiality (Williams, 2007).
Informed consent:
This was a document signed by both the patient and the rehabilitating team to ensure all moral obligations are respected while undergoing the assessment and treatment plan. The rehabilitating team provided Adams and his parents with all the needed information and asked him to decide on signing for the rehabilitation or not.
Confidentiality:
All the information about Adam’s drug use history was kept confidential. The patient and his parents were taken through the confidentiality form in order to eliminate any doubt because what Adams was doing was illegal.
References
Drug abuse and addiction media guide. (2001). Bethesda, Md. (6001 Executive Blvd., rm. 5213, Bethesda, 20892-9561): National Institute on Drug Abuse, National Institutes of Health, Dept. of Health and Human Services.
Duncan, E. A. (2011). Foundations for practice in occupational therapy (5th ed.). Edinburgh: Elsevier.
Finn, p. (1994). “Addressing the needs of minorities in drug treatment,” Journal of Substance Abuse Treatment, 11. 325-330.
Kalivas, P. W. (2003). “Predisposition to Addiction: Pharmacokinetics, Pha rmacodynamics, and Brain Circuitry.” The American Journal of psychiatry, vol. 160, No. 1,. 55-87.
Maville, J. A., & Huerta, C. G. (2008). Health promotion in nursing (2nd ed.). Clifton Park, NY: Thomson Delmar Learning.
National Institute on Alcohol Abuse and Alcoholism. (2002). Alcohol and Minorities: An
Update. U.S. Department OF Health And Human Services. Publication 55. Retrieved from:
http://pubs.niaaa.nih.gov/publications/aa55.htm
National Institute of Drug Abuse. (2013). Drug Facts: Cocaine. Retrieved from:
http://www.drugabuse.gov/publications/drugfacts/cocaine
SAAS Update. (2007). State Association of Addiction Services Update, Vol. V, No. 12. September.
Straussner, S. L., & Fewell, C. H. (2006).Impact of substance abuse on children and families: research and practice implications. Binghamton, NY: Haworth Press.
Williams, R. (2007). The Ethics of Substance-Abuse Issues. Retrieved from;
http://www.ascaschoolcounselor.org/article_content.asp?edition=91§ion=140&article=927
