Addiction Issues

Jessica got here on her personal looking for help along with her drug use/abuse. She has come to us today to figure out the principle cause of her addiction issues. Through this evaluation I will be ready assist Jessica find the correct remedy to aid her in restoration. Although American individuals solely make up 5% of the worlds populations, we use 60% of all illicit medicine (Doweiko, 2015). This evaluation is to assist Jessica find the proper treatment choices.

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Sources of Information

The supply of data for this assessment was acquired from the interview process.

All information is predicated on statements given by the consumer, her highschool officials, and from her mother and father. Jessica’s mother and father tried serving to her and for brief intervals she was in a place to refrain from utilizing, but ultimately she relapses.

Background Information

Jessica was a “typical teenager” she grew up with both parents and her siblings. Jessica is the youngest of 4 daughters. She enjoyed household activities, had many pals and enjoyed Art and French class while at school.

She has said that “drugs and alcohol had been never an issue; I never drank or smoked in high school.” According to Jessica her boyfriend was the rationale she started utilizing heroin. Jessica had by no means used heroin till her boyfriend jab her with a heroin filled syringe. She started utilizing every few weeks and then escalated on to day by day use. Her drug use obtained her expelled from faculty just two months from her commencement, she was mendacity, and stealing cash to assist her behavior.

She tired tp get assist, Jessica states “I was going via counseling and I informed my therapist about all the mendacity and utilizing behind my parents again.” Her parents are supportive and have tried to assist her with none success.

Current Status

According to May (2007), Jessica’s present standing is more than likely the breakdown stage. She is remorseful and has feeling of disgrace and remorse for her actions. The mendacity to her mother and father and stealing from them is the most important source of her disgrace. She additionally regrets not ending college with the relaxation of her class. According to May (2007) Jessica has loss of will energy, she really desires to give up but battles the urge to make use of again. She experiences craving which Doweiko (2015) describes as an intense, subjective, emotional and physical experience for the individual that varies in depth between individuals. Jessica has been sober for ninety days however does feel the urge to use once more. She desires to achieve her GED or end highschool but struggles every day to remain sober.

Indicators of Use/Abuse/Dependency

Doweiko, (2015) States opioid use or abuse, as identified within the DSM-5 has 5 sub-forms, opioid use dysfunction, opioid intoxication, opioid withdraw, different opioid-induced issues, and unspecified opioid-related disorders. It is the equivalent of a narcotics addiction. Using the factors talked about, it is evident that Jessica makes use of and abuses heroin, due to this fact it’s likely the she has an Opioid Use Disorder (OUD). Jessica has tried to stop on her own several instances without any success. This is widespread as 50-90% of patients handled for a substance use dysfunction, they often instances relapse throughout the first ninety days (Doweiko, 2015). Jessica absolutely realizes the necessity to give up and he or she needs to take action.

Attitude and Behavior

Jessica was expelled from college after bringing medicine on the senior class retreat journey. She would lie to her dad and mom in addition to steal from them to support her habit. She now seems determined to give up using heroin. She stories having sturdy cravings which lead her to use again even if only a couple of occasions.

Social Functioning

Throughout school Jessica had good friends with her fellow classmates. Currently, the only associates mentioned are others who use heroin as properly. She has a supportive family that’s keen to do what they’ll to help her on her street to recovery.

Occupational Functioning

Jessica does have a job however only as a end result of she works for her father. There was no point out of her ever holding another job, this seems to be her first job.

Financial Aspects

Jessica works for her father whereas trying to stay sober, but she has no training and no prospects of a greater job. She wants to complete highschool or no much less than get hold of a GED. It was not reported as to where she presently resides or if she has any bills to pay.

Familial Relationships

Jessica’s parents are loving Christians and really supportive, they need to assist their daughter but usually are not certain what to do. Her father gave her a job at his business to offer her something to do. The lying and stealing was exhausting on them but their faith and love for their daughter they proceed trying and help her. No point out of how her addiction has affected her sisters.

Legal History

Jessica has admitted to stealing from her parents and having medicine at a faculty retreat, which value her expulsion from school. No current authorized points to report.

Health History

There are no reported health issues presently. Jessica could experience long term effects in the future after getting clean. Some individuals who use heroin long term have developed: insomnia, collapsed veins for individuals who inject, damaged cartilage tissue contained in the nostril for individuals who snort it, an infection of the center lining and valves, abscesses (swollen tissue crammed with pus), constipation and stomach cramping, liver and kidney illness, lung complications, including pneumonia, psychological issues corresponding to melancholy and delinquent persona dysfunction, sexual dysfunction in men, irregular menstrual cycles in girls (National Institute on Drug Abuse, n.d.). Jessica does appear to suffer from some melancholy and self esteem issues, each time she has a failed try at sobriety, she feels extra down on herself. Heroin typically contains additives, corresponding to sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or mind, causing irreversible harm. Also, sharing needles to inject medicine along with impaired judgment from drug use will increase the danger of contracting infectious diseases similar to HIV and hepatitis (National Institute on Drug Abuse, n.d.). If Jessica continues to make use of she could possibly overdose on heroin, which may cause psychological issues due to lack of oxygen to the mind in addition to demise.

Spiritual History

Jessica comes from a Christian home and her family attended church regularly. Jessica doesn’t believe church helps together with her addiction. Jessica did not state if she believes in God or if she goes to church as a outcome of her household does. Due to her wrestle with addiction Jessica could have doubts about God. After multiple failed makes an attempt at staying clear she might battle some emotions of failure and would tremendously benefit from a relationship with God. It has been hypothesized that every addiction, at its core, is a illness of the spirit (Doweiko, 2015). Jessica drug use is her trying to fill the hole by which only God can fill.

Diagnostic Impression

Based on the DSM-5 Jessica meets the factors necessary to think about substance abuse disorder. According to the DSM-5, a number of the indicators of a substance abuse dysfunction embody preoccupation with continued substance use, intoxication at inappropriate times, discount in social, occupational, or recreational actions, and continual use regardless of social, emotional, or vocational issues attributable to the substance (Doweiko, 2015). Jessica has repeatedly relapsed, the longest she has clean and sober is a couple of months and then she resumes her heroin use. She states that some relapses are short solely a use or two and he or she tries again and other times she begins using daily once more for a longer time frame. Jessica’s cravings appear to get the best of her and she or he incessantly gives in to them. She does feel immense guilt and shame when this occurs and tries to cease utilizing once more. Her loving family appears to be considered one of her main motivators to get and stay sober. The incontrovertible fact that she took the first step and got here in and asked for professional help shows that she indeed wants to be sober. She has been in counseling prior to coming in however she was not an any treatment program.

Recommendations

Jessica should be admitted right into a detox inpatient for 3-5 days, then admitted to outpatient remedy program for ongoing treatment. She has the support of her household and willingness to get and keep sober. I would also advocate that Jessica attend group conferences such Narcotics Anonymous (NA) or a more faith based group since she was introduced up in the church.

According to the continuum of chemical use Jessica falls into degree 3. Level 3 is late downside use/early dependancy: people who fall into this category may be physically dependent on a compound, and presumably also expertise the traditional withdrawal symptoms for the compound being abused if they want to abruptly stop utilizing alcohol or drug of selection (Doweiko, 2015). There are a variety of therapies including medicines and behavioral therapies which have been shown to be efficient in serving to folks stop heroin use. Medicines embrace buprenorphine and methadone. They work by binding to the same opioid receptors within the mind as heroin, however extra weakly, lowering cravings and withdrawal symptoms. Another therapy is naltrexone, which blocks opioid receptors and prevents opioid medicine from having an effect (National Institute on Drug Abuse, n.d.).

Behavioral therapies for include strategies such as cognitive-behavioral therapy and contingency management have been shown to be efficient. Cognitive-behavioral therapy helps modify the patient’s drug-use expectations and behaviors and helps effectively handle triggers and stress. Contingency management provides motivational incentives, such as vouchers or small money rewards for positive behaviors such as staying drug-free. I would additionally recommend a licensed recovery peer coach for Jessica. The peer coach could be someone who has been through related conditions because the client and has handled every little thing somebody goes by way of in early restoration.

A peer coach offers life experience and recommendation on a stage most skilled professionals can not provide. The peer coach relates on a personal stage and helps with giving recommendation primarily based on life experience. Client will need a blood workup, followed by a urine drug display, and a medical examination. Within the medical examination her lack of ability to remain focused might be tested to rule out or determine any underlying analysis previously ignored. These behavioral remedy approaches are especially efficient when used along with medicines (National Institute on Drug Abuse, n.d.).