Case Study Application Paper : Avery, Co Occurring Disorders Essay

According to the SAMHSA (2010) report on the national survey on drug use and health almost 22.5 million people are reported to be associated with substance abuse disorder (SAMHSA, 2010). This illness was found to be very common in all age groups, both sex, and seniors. There are several effects on these individuals and their families. Many people who suffer from substance abuse disorders fail to acknowledge these serious consequences. First of all, no response of pain relief can be seen with smaller doses of pain medications, as their bodies are used to high levels of various substances at the same time. Nurses become frustrated when they try to treat and help these patients with pain. Sometimes it is difficult to think about ethical principles when nurses have to deal with such patients with pain and suffering.

As previously discussed, the program the author would choose to evaluate is MAT treatment programs. This population consists of individuals that have been diagnosed with opiate use disorder, and receive opiate-substitution medications, such as Methadone or Suboxone. These program evaluations would be consumer-centered, performed in the clinics they receive services. Interested stakeholders would include the treatment center where the participants receive services, as well as other MAT service providers. Additionally, the funding sources for these individuals and program centers, such as county, state, and federal agencies, along with medical insurers, would also gain value from the program evaluation research.

The United States currently faces an unprecedented epidemic of opioid addiction. This includes painkillers, heroin, and other drugs made from the same base chemical. In the couple of years, approximately one out of twenty Americans reported misuse or abuse of prescriptions painkillers. Heroin abuse and overdoses are on the rise and are the leading cause of injury deaths, surpassing car accidents and gun shots. The current problem differs from the opioid addiction outbreaks of the past in that it is also predominant in the middle and affluent classes. Ultimately, anyone can be fighting a battle with addiction and it is important for family members and loved ones to know the signs. The cause for this epidemic is that the current spike of opioid abuse can be traced to two decades of increased prescription rates for painkillers by well-meaning physicians.

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

Co-occurring disorders can be difficult to treat due to the complexity of symptoms. Both the mental health and substance abuse disorders have biological, psychological, and social components assessed throughout the treatment process. Co-occurring disorder individuals battle to maintain their sobriety as they need to find services for both mental health and support groups catering to their unique needs.

America has a major problem with opioid addicts, and many facilities are helping the addicts by providing safer options to taking the drugs their bodies crave. Methadone clinics are places where people addicted to opioids can receive medicine-based therapy. Opioid use, drugs such as heroin, morphine, and prescribed painkillers, has increased in the US with all age groups and incomes. People become addicted to these drugs when they are prescribed, recreationally used with other addicts, or they are born addicted. Many health institutions are addressing this issue with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted

When concerning the patient situations there are some important facts that need to be reviewed. The important facts about this case is the patient was a 16 years old guy that got in an automobile accident. The patient stated that he was in a methadone treatment program. A methadone are drugs approved for use in treating opioid dependence patient such as

Considerable cautions have been obtained throughout the United States to decrease the misuse of prescription opioids and helps to minimize opioid overdoses and related complications. Even though the pain medications have a significant part in the treatment of acute and chronic pain situations, it sometimes happen that the high dose prescription or the prescribed medications, without having enough monitoring, can create bad outcomes. It is always a dilemma for the providers to find who is really in need of pain medications and to identify those who are questionably misusing opioids.

2. The patient was provided with weekly sessions, random UDS testing, group sessions if needed, and any other case management the patient needed. The patient came to the clinic in need of treatment for his opioid dependence and was compliant with his treatment.

Until recently, there was a dramatic disconnect between this research and drug court operations. The consequences of this disconnect included relapse, overdose, and death. While drug courts were designed to accommodate those in need of medical care, most operated under the misguided and dangerous practice of requiring defendants, as part of their successful program completion, to stop taking life-saving addiction medication prescribed by their physicians. This practice, which is at odds with decades of scientific and medical research, put individuals with opioid addictions in the precarious position of either having to stop taking their effective medication and risk relapse or use their medication and face incarceration. To compound matters

A psychiatrist in a methadone clinic in Northeast Washington, D.C. works with patients who are addicted to drugs. Some of her patients suffering from addiction

Rosa Cunningham (full name is Rosa Lee) is a 53 year old African American female client of average height, slight build, and is appropriately groomed. She has 8 children, 2 of them being female and 6 males, all adults. Rosa is a widow and reached this status after being separated from her deceased husband for many years. Rosa is currently hospitalized for pneumonia, and has been hospitalized several times in her life for diferent illnesses. Rosa’s medical history as self-reported is HIV and seizures. Rosa is a heroin addict and has been this way for several years. Rosa is involved with the local methadone clinic and receives 55mg of methadone daily. Even by receiving this daily dose of methadone, Rosa continues to use heroin. Rosa has several legal and health issues that are present also, despite which she continues to use heroin. Rosa has a lengthy criminal history to include arrests for prostitution, larceny, and selling drugs. The reason for today’s assessment is a referral made by the social worker at the hospital in which Rosa is a patient at and discharge planning is to be made for aftercare.

The National Center on Addiction and Substance Abuse provides guidelines and recommendations to healthcare providers in terms of how to screen for an addiction. Opioid addiction is screened primarily through patient interviews involving both specific and open ended questions about their lifestyle, mood, and drug use. A psychiatric exam may also be administered to look for psychological factors indicating an addiction such as depression, anxiety, and other psychological symptoms related to addiction and withdrawal. Withdrawal is evaluated by gradually taking a patient off opioids and if symptoms of withdrawal are found the severity of the withdrawal itself is then evaluated.2 If a patient is diagnosed with an addiction to opioids then the transition to tertiary prevention, or treatment will occur. However, treatment will only occur if early detection and screening techniques are utilized fully by healthcare provider otherwise it is likely an overdose will kill the opioid

The opioid war can be resolved through the combination of counseling and extended addiction services for individual treatment plans. The program at Center for Behavioral Health Elizabethtown provides counseling and intensive therapy both during the addiction process and for up to a year for all patients after leaving the program (Zsigray 4). The treatment of the addict, and the mental illness and emotional disorders attached to addiction, can fix the epidemic. Patients who treat the addiction by use of corrective therapy are more likely to stay clean than patients who do not (Zsigray 3). Therapy and counseling are a vital part of the recovery process.

Many individuals suffer on a daily basis with one mental disorder let alone multiple. Few have the resources needed to cope and can turn to other methods of improvement without thinking about the potential outcomes of addictions and worsen their condition. Mental disorders are often than not linked to substance abuse because of the stigma placed over humanity. Society places such a constricting grasp on what is considered normal that people are hiding their symptoms and attempting to mask them to get by; only causing chaos to their lives. It is easier to try an attempt to mask symptoms with alcohol and other narcotics. I chose to focus on Borderline Personality Disorder (BPD) mixed with Substance Abuse for the focus of this piece. All of this can be alleviated by erasing the stigma we 've placed and given these people the many methods of help they seek. One of the first things to think about is the comorbidity between abuse disorders and other mental disorders from an epidemiological standpoint. What is comorbidity exactly? The term was introduced to “refer to any distinct additional clinical entity that has existed or that may occur during the clinical course of a patient who has the index disease under study.” Which basically means when two or more medical conditions ensue simultaneously or consecutively in the same individual they are commonly said to be comorbid. 1