Case study Mental Illness and Addiction

Case study Mental Illness and AddictionDescribe center ab engross and how it differs from perfume dependence.Substance squall is when an one-on-one Overindulgences in an addictive substance (New Oxford Ameri house Dictionary. According to the Neurobiological Causes of Addiction, substance exclaim is a Maladaptive pattern of do drugs use lead story to impairment or distress presenting as one or more of the following in a 12 month period of time (Erickson Wilcox 2001)Recurrent use leading to also-ran to fulfill major obligationsRecurrent use which is physically hazardousRecurrent drug-related legal problemsContinued use despite social or social problemsand the person has never met the criteria for substance dependence (Erickson Wilcox 2001). A person that has a substance dependence is when an individual uses a substance despite the negative affects that may occur, such as withdrawal, and compulsive behavior. According to Erickson, Drug dependence is a maladaptive pattern of drug use, leading to impairment or distress, presenting as common chord or more of the following in a 12 month period (Erickson Wilcox 2001)Tolerance to the drugs actionsWithdrawalDrug is used more then meanInability to control drug useEffort is expended to obtain the drugImportant activities argon replaced by drug useDrug use continues in spite of negative consequencesWhen an individual has a dependence to a substance the individual has a mental and physical attachment with the substance. It is this link between the drug and the body / mind that feces incur devastating and lasting effect on the individual who has the dependence.5 pts some recovery/treatment programs stress full(a) abstinence as a goal, while other advocate harm reduction. What are the advantages/disadvantages of each approach?Abstinence is like to what it sounds the individual is not allowed to drive-to doe with in the substance that they are addicted to, and these types of programs are effective, but t he individual has to be resulting to devote themselves to the program.Some of the advantages of abstinence can allow in getting the individual healthy physically and mentally. The positive side of abstinence is that the individual is no longer destroying personal property and committing crimes to finance their addiction. Therefore, abstinence keeps deal knocked out(p) of the legal system including serving time for criminal crimes and dealing with the court system for loosing custody of their children. 12 step recovery groups such as AA and NA advocate for abstinence to give raft what they call, Recovery and a change for a better life that is free from active addiction (Personal communication, Wright. J, 2010) Abstinence provides a support group that allows the addiction to be normalized, and allow the individual to link up with other people who are slaves to a dependency. The individual is able to claim an since of empowerment by being surrounded by others, who are able to ke ep the individual in check on their addiction and personal goals.The disadvantages of abstinences, argon most disturbing is the elbow room abstinence can segregate mentally ill persons from being able to engage in treatment. This is because many people beget diagnoses that require Benzodiazepines, Amphetamines and even Methadone which treatment providers believe to be highly addictive. There is a theory that a person in treatment can engage in services if they are high on prescriptions (Personal communication Wright. J. 2010) The main program for abstinence is AA or NA and they are based on spirituality, this could be a conflict for some of the individuals who are in treatment, because there religion may contradict that of the programs. It is also important to remember that the individual has to unavoidableness to change their life for this program to work. AA and NA also tell the individual that they involve no power over their addiction, it does not allow the individual to hav e a feeling and since of empowerment. It seems to take the power away for the individual and puts all the counselling on the addiction. Also AA and NA preaches the idea that you have to go to the meetings every day and that you will always be an addict and that you can never be without the addiction and that you can never over come the addiction. Also they have to be willing to alter their lives and commit themselves to the program fully.Harm reduction is a good alturnative to abstinence for individuals who cannot stop their use because they are psychologically dependence to the substance. Harm reductions can admit such ideas and concepts like, using the substance less, using the drug every Wednesday or even changing out their needles for clean ones. Some of the following are advantages and disadvantages according to the 2007 Journal of Drug Issues in side of meat and American Drug Clients (K. Phillips, h. Rosenburg A. Sanikop).Harm Reduction Advantages and DisadvantagesInterven tionsAdvantagesDisadvantagesMethadoneReduces/eliminates/stabilizes illicit drug use facilities detox/relives withdrawalMore addictive and worse withdrawal then heroin, Substituting one addiction for another.Substitute AmphetaminesKnown potency, Content.Decrease need for street drugs. nuisance reductionCould encourage to use more on top and OD Diversion to black markets.Needle ExchangeDisease Prevention, Removes temptation to share or reuse (needles)Disease PreventionLower rates of AIDS and STICommunity harm/inappropriate disposal, Makes it easier to inject.Encourages useDrop in CentersSafer environment NOS, OD saloon/ Prevents harm treatment facilitationEncourages drug use/Risk compensation.Place where drugs can be sold.LofexidineEases pain of withdrawal non-opiate alternativeEncourages detox/eases withdrawalDoesnt help affluent with the withdrawal symptomsDrug has specific side effectsNaltrexoneTemptation resistanceRelapse prevention because use is waste of moneyRelapse Preventi on/ helps substance abuser quit, blocks the effects of HeroinCan be used as a weapon, Clients wont take itIn the states, Harm Reduction therapy has a stigma disposed to it that some clinical practices and professionals have attached to it, detouring individuals with substance abuse issues to use Harm Reduction. This type of therapy also does not assist with co-occurring dependancies that the individual may have. It tends to focus on the chemical that the individual is addicted to and not the cause of the dependancy. It does not allow for the individual to isolate and get to the root of the problem, however, it does save money in the medical and prison systems. The needle fill in, was started after the out break of HIV and AIDS and the come up of individuals who were diagnosed with HIV and AIDS has gone down since the needle exchange was influenced. As well as the number of individuals who are in prison for substance abuse has gone down because there are treatment programs that in clude methadone that can help the individual come off their addiction to an opiate.5 ptsAlcoholism has been described as a bio-psycho-social dis dress. If you were performing an assessment of a defendant what factors would you look for in the client history?Bio-psycho-social is broken down into the followingBiological Addiction is addiction that runs in the families and there maybe catching involved in the process of addictions, but some of the individuals have a biological predisposition to addictionPsychological Addiction That addiction is a well-read behavior. This can include, domestic violence and learning how to use a drug. One becomes obsessed by the PLEASURE that the substance can provide.Social Aspect Environments that individuals bewilder up in and that environment may reinforce addictive behaviors.It is these concepts that create the bio-psycho-social theory, it is an idea that is steeped in the theory of person in environment. It takes in account the individuals biolo gy, psychological health and social wellbeing and support to fully generalize the root of the persons addiction. According to the Handbook of Forensic Mental Health ( D. Springer A. Roberts 2007 p. 350-352) the following are questions and discipline that you have to gather in order to be able to fully complete an assessmentPresenting Problems Record current problems as reported by the younker, family, referral source and any pertinent others, Include the history and development of the problem, circumstances surrounding the problem and the previous attempts to solve the problem. Development (birth to current age) describe antenatal care, birth, achievements of developmental milestones, delays and birth defects.Family Background describe the family constellation, family functioning and communication. Include socioeconomic, educational and occupational information. Describe family childrearing and parenting tactics.Academic narration Describe previous diagnoses and the history of psychological problems and services. Include medication history and any history of self-injurious behaviors and or suicide attempts.Psychological History Describe previous diagnoses and the history of psychological problems and services include medication history and any history of self-injurious behaviors and or suicide attempts.Substance Abuse History Describe the youths use and abuse of all substances include the length, method, and mend of use and the families history of substance use.Juvenile Justice or Legal History Describe previous encounters with the juvenile justice system and the history of smuggled behaviors and status offense. include timeline, type, and circumstances of offense as well as the family history of legal problems.Violence and Abuse History Detail psychological, verbal, physical, and sexual abuse of the youth and include a timeline. Identify perpetrators and describe whether the abuse occurred in or outside of the family. Describe any family or dating vio lence that the youth perpetrated. include any other traumas that the youth was exposed to.Medical History Describe the history of medical conditions diseases and medication of youth Include the family history.Cultural History Identify the ethnicity and rase of the youth and family include any issues noted regarding bicultural identity, immigration status, language barriers, acculturation and discrimination.Lethality Clearly identify any concerns with lethality of the youth either towards him or herself or others and describe the plan for addressing this lethality.Bio-psycho-social is a holistic approach when dealing with an individuals addictive behavior. It is based on a continuum approach, that is supported by a since of empowerment. It allows the individual to understand why they many have started to be addicted to a substance that is plaguing them, and gives them the tools that is needed to understand their addiction and how to prevent themselves from relapsing.5 ptsHistorically , a number of theories or models of inebriantism have evolved. What are these models and what is their relevance for today?These models give a guideline and help create an understanding in why people become addicted to specific substances. These models range from biological reasoning to environmental, but they are all linked in labeling to discover why people become addicted to substances they all strive to create a public understanding of addiction. They do not try to make excuses for those who are addicted, but they try to understand why addiction occurs.Theoretical manakins of Alcohol/Drug AbuseFrom the Concepts of Chemical Dependency by H. DoweikoMoral ModelTemperance Model religious ModelDispositional Disease Model total ElementThe individual is viewed as choosing to use alcohol in problematic mannerThis model advocates the use of alcohol in moderate mannerDrunkenness is a sight that the individual has slipped from his or her intended path in life.The person who becomes addi cted to alcohol is someways different from the nonalcoholic. The alcoholic might be said to allergic to alcoholEducational ModelCharacterological ModelGeneral Systems ModelMedical ModelCore ElementAlcohol problems are caused by a lack of adequate knowledge about harmful effects of this chemicalProblems with alcohol use are based on abnormalities in the personality structure of the individualPersonal behavior must be viewed within context of social system in which they liveThe individual use of alcohol is based on biological predispositions such as his or her genetic heritage read/write head physiology and so on.(Harold Doweiko. 2009. pp. 30)The models that have the most relevance for today has to be the medical model and the general systems model. Because by looking at the person in a holistic way we can understand that the individual is affect by addiction in three ways biologically, psychologically, and socially and those two theories envelop those ideals. I think that when you u nderstand the individuals biological and social characteristics, you will understand there addiction.5 ptsIn describing the neurobiology of addiction, the term neuroplasticity is used to describe what brain process?Neuroplasticity is when the brain is altered overdue to chemicals, and it is forced to change in order to adapt to the chemical. When the chemical has been removed from the individual withdrawal starts to occur, because the brain has a difficult time functioning without the substance it has been forced to adapt to. Because the brain is good at making adjustments the body is capable of adapting to the toxic chemical, and the body learns how to function with the additive. Without the chemical the body has to alter itself to learn how to function without the chemical.5 ptsDr. Eugene Prochaska has developed a treatment approach based on Stages of Change. What is the thinking behind this model and how it is used in treating substance abusers?The direct of this model is to u nderstand how the cognitive and behavioral approaches affect the individual who is addicted to chemicals. According to Porchaska the, Purpose (of) the transtheoretical model (TTM) of health behavior seeks to bridge the cognitive and the behaviouristic approaches by positing a series of stages in modifying behavior in only some of these are cognitive processes pertinent and The model includes four main constructs the successive stages of change processes which people typically use to facilitate change decisional balance, which predicts whether change will occur and self- efficacy, the persons confidence they can make changes (Prochaska. 1985. pp. 1).Stages of ChangeStages of Change and the Transtheoretical Model By E. ProchaskaStagesDescriptionPre-contemplationThe person has no intent in changing the behavior, usually within the next six months. This maybe due to lack of information or confidence. The person is unmotivated and will resist discussing or thinking about making the cha nge. They are not ready for interventions.ContemplationThe person expresses and spirit to take action within six months. They are aware of the benefits and cost of making the change and this balance may keep them in the phase for a long time. They are not ready for an intervention that expects immediate action.PreparationThe person intends to take action in the immediate future. They typically have a plan of action and they have taken some preparatory action. They are ready for traditional action interventionsActionThe person has specific changes to their lifestyle nutritionThe person works to prevent relapse during this phase their confidence increases as they continue with their new lifestyle.TerminationIn principle the maintenance stage will lead to a phase in which the person is no longer tempted to revert to their former behavior and the change is complete.This model suggest that in order to over come an addiction you have to go though a linear model. I do not think that the i ndividual with the substance abuse has to go though all these steps in order to kick the habit. I also believe that this model places all the blame on the individual because it does not take into account the individual biology and or the environment that the individual is surrounded by. The thinking behind this model is that these are the stages that an individual who has a substance abuse dependency must go though in order to become clean and if they are able to follow this model they will finally be able to kick the habit.5 ptsHow is crystal meth different from other stimulants such as cocaine? What are some of the semipermanent effects associated with meth use?According to the Powerpoint provided by the Department of Health and Human Services (SHMHSA) the differences between methamphetamine and cocaine areCocaine effects 1 to 2 hours.Methamphetamine effects 8 to 12 hours.More intense rush or initial pleasure (I would add.)Withdrawal from methamphetamine can cause more intense sym ptoms and last longer.The Long term psychological effects of using meth areConfusionLoss of ability to concentrate and organize informationLoss of ability to feel pleasure without the drugParanoiaInsomnia and fatigueMood swingsIrritability and angerDepressionAnxiety and panic disobligeReckless, unprotected sexual behaviorThe more sever psychological effects can includeHallucinationsSevere depression that can lead to suicidal thoughts or attemptsEpisodes of sudden, violent behaviorSevere memory loss that may be permanentThe chronic physical effects areTremorWeaknessdry mouthWeight loss/malnutritionIncreased sweatingOily skinSoresHeadachesSevere problems with teeth and gums Sever PhysicalSeizuresDamaged blood vessels in the brain/strokeDamaged brain cellsIrregular heartbeat/sudden deathHeart attack or chronic heart problemsKidney failureLiver failureTweakingInfected skin sores5 ptsCitationsDepartment of Health and Human Services. SHMHSA.(Year unknown) Session 4 methamphetamine and co caine, TCRIM 361 Summer 2010. University of Washington Tacoma.Doweiko, H. (2009). Concepts of chemical dependency psychological models of substance use disorders. Brooks/cole cengage learning. Belmont CA. ISB 13-978-049550580-8Erickson, Carlton K. and Wilcox, Richard E.(2001) Neurobiological causes of addiction, journal of social work practice in the addictions, 1 3, 7 22DOI 10.1300/J160v01n03_02 URL http//dx.doi.org/10.1300/J160v01n03_02Phillips, K., Rosenberg, H., Sanikop, A. (2007). English and american drug clients view of the acceptably, advantages and disadvantages of treatment and harm reduction interventions. Journal of Drug issues, 37(2), 377-402. Retrieved from Academic Search Complete database.Prochaska, J. (1985). Stages of change and the transtheoretical model.Springer W., Roberts A., (2007) Handbook of rhetorical mental health with victims and offenders assessment, treatment, and research. Springer Series on Social Work. New York. ISBN 0826115144Wright. J. (2010, Au g. 8). Personal communication. University of Washington.