Diagnosis And Classification Of Substance Use Disorders

According to the Diagnostic Statistic Manual 5 (DSM-5) substance use disorder is when the individual has a dependency on alcohol or drug, followed by penetrating craving and antisocial behavior to acquire the substance. The terms substance abuse and substance dependence refer to substance use disorder, which has been separated into three classifications as follows

During the state of SUD it is question whether the individual suffering from such a disease should be held accountable for their actions. Another distinguishing factor between SUD and abuse is that SUD are not static entities but rather evolve over time (Doweiko, 2015). This evolution or rather stages are ranged from 0-4 which include total abstinence to middle to late stage addiction. SUD must also meet certain criteria’s in the DSM-5 manual. There are 4 general categories to determine if an individual suffers from SUD (Doweiko, 2015). The categories consist of impaired control over substance, multiple attempts to quit, activities center around getting substance, using, or recovering from using, and pharmacological effects of the drug. Manifestations, spiritual, vocational, primary disease, and potential to be fatal is also considered in the diagnosis criteria of SUD. Substance abuse on the other is used when individual uses a substance or compound for no medical reason or the substance is used in excess (Doweiko, 2015). Abuse has no physical dependency from the chemical, has no automatic physical

In October of 2002, the Food and Drug Administration (FDA) approved the use of Suboxone for the treatment in the United States of opiate addiction (Mintzer, 2007). It is a medication-assisted treatment; however it “does not require participation in a highly-regulated federal program such as a methadone clinic” (Stuckert, 2013). It does not cause the high or euphoria feeling associated with opiate dependency. In fact many patients that have taken the treatment have said that they have felt little more than having more energy and no real high at all (Thompson-Gargano, 2004).

There are many assessment processes that are used to identify substance abuse as well as many other disorders that are addictive. These processes include the SBIRT, AUDIT (Alcohol Use Disorders Identification Test), NIDAMED, CAGE AID (which is used frequently within the counseling foundation), AUDIT-C, and also the DAST-10 which is an assessment process used to evaluate drug abuse within the patients. These are many different processes that are currently used to identify these addictions in clients. The activity of identifying these processes can be over a period of time or can be evaluated in that same day or after the evaluation is completed.

There are three predominate forms of Medication Assisted Treatment (MAT) that have proven effective in combating opioid use disorder. Methadone, buprenorphine, and naltrexone have all shown to be effective in the treatment of substance use. When prescribed and monitored properly, MAT has been shown to reduce illicit drug use and reduce the rate of accidental overdose. However, while as many as 2.5 million people are suffering from substance use disorder, less than 40% have access to MAT

¨ More than a quarter of a million Americans are enrolled in methadone clinics, where they participate in “methadone replacement” or “methadone maintenance” to treat narcotic addictions to heroin or morphine, or prescription painkillers like oxycodone, hydrocodone, OxyContin or Vicodin.¨ (Novus Detox, 2016) Clinics that treat opioid addiction use several combinations other than methadone to be effective. In addition to daily methadone treatments, there are also random drug test to make sure the individual is complying with the program. There is also individual and group counseling that provides education and support with each being customized with goals set forth by the patient. Some addiction require patients struggling to seek professional help with a psychiatrist and/or speciality

Clearly, it would be in the best interests of society to address the problem with substance use disorder. There are ten separate classes of drugs, which include alcohol, caffeine, cannabis, hallucinogens stimulants, and unknown substances (American Psychiatric Association, 2013). In order to diagnose someone with substance use disorder the DSM 5 (2013) lists eleven separate criteria. The individual may require higher amounts or longer periods than was originally planned. Obtaining, using and recovering from the effects of the drug may take the majority of their time. The daily routine revolves around the drug. When the

Objective: This study compared the effectiveness of methadone, Subutex, and Suboxone in reducing illicit drug use during treatment for opioid dependency and retaining patients for the duration of treatment.

First, for providers to use opioids as the first option in prescribing pain killers needs to be addressed. Knowing that opioids are very addictive should sway providers to look for other options for their patients before looking towards opioid type drugs. Second, once a patient is prescribed opioids for pain management, there needs to be limitations placed on how many pills the patient can have at one time. There also needs to be a limitation placed on the amount of time a patient can use any form of opioids. Third, once a patient’s prescription runs out, they often times start looking to find that same high by buying these drugs illegally off the streets. Therefore, after a patient stops using an opioid medication, they need to have some type of specialty care available to them (mandatory if used for a prolonged period of time) to address any potential withdrawal symptoms; care that can provide counseling and or medications that enable the patient to be weaned off of the drug. Fourth, the need to identify why patients are not seeking recovery is crucial. Not many opioid addicts seek treatment; the first step in recovery is to seek help. Fifth, determining how to get opioid addicts into a recovery program will help exponentially to get people away from opioid use and on the road to recovery. Sixth, opioid addicts do not have high success rates for continued recovery after leaving a treatment program. Identifying the needs of the addicts after treatment is one of the most important elements to staying clean and

A literature search was conducted using Ovid MEDLINE (1946 to May Week 4 2015) and Embase (1996 to 2015 Week 22). Keywords used in the search were suboxone or buprenorphine, methadone, opioid, dependence, efficacy, and outcome. From there, 187 results were limited to English language and Humans studies, yielding 178 articles. Of those, 10 results

The participants were randomly assigned to either two weeks of detoxification using Suboxone or twelve weeks of extended Suboxone treatment where the daily dose was gradually decreased starting at week nine and discontinued at week twelve. Follow-up evaluations conducted at six, nine, and twelve months showed increased rated of opioid use in both groups compared to the end of the treatment period; however, rates of opioid use were lower in the extended treatment group (Leonard, 2009).

Substance abuse, or substance use disorder (SUD), is recognized by the medical community as continual overindulgence of an addictive substance such as drugs and alcohol. The extent of a person’s involvement in the disorder is measured by the amounts normally consumed and the length of time between periods of consumption. Substance abuse does

Client has no know history of previous treatments. Client desires treatment due to unhappiness with current life style. Client states that his longest abstinence from alcohol is 4 days, nicotine an hour, and marijuana and cocaine 1-2 years over the last 5 years. Client recognizes several triggers for drinking episodes (social anxiety, loneliness, fear, feelings of inadequacy, and guilt). Client is not experiencing any cravings for chemicals at this time (currently using nicotine). Client states he has current problems with family resentments and anger, self-esteem, and anxiety that are unresolved. At this time, potential for relapse is moderate to severe. Client a limited support network and no relapse prevention plan.

The third and final stage of recovery is known as late recovery, and involves a client finding growth and meaning in life. In this stage, relapse may be less frequent as a sense of purpose is found. As this stage is found only by enduring great challenges, a client may not be as tempted by relapse and the act of back tracking in their recovery may seem tiresome and unworthy of their time. However, though a deep awareness of the consequences of substance abuse is profound, relapse is still possible if an addict forgets that he or she has a disease that is incurable and succumbs to the enticement of “just this one time can’t hurt” or has the thought that “I have been clean for so long. I am cured.” Bill W. stated in his book Alcoholics Anonymous that “This is the baffling feature of alcoholism as we know it-this utter inability to leave it alone, no matter how great the necessity or the wish” (pg. 34). Complete abstinence is the only choice for those with the disease of addiction, and so many recovering addicts forget this simple realization in the late recovery stage.

‘Recovery from a mental health problem can be understood either as an outcome or as a process.’ Also known as ‘clinical recovery’ an outcome is present depends on whether the symptoms/problems are present or absent (Serafín Lemos-Giráldez 2015). Usually involving a reduction or absence of symptoms and a significant improvement in occupational and social functioning, an outcome does not change from person to person. On the other hand, individuals who go through a process in order to live a joyful and fulfilling life, experience personal recovery. (Serafín Lemos-Giráldez 2015). This form of recovery involves learning to become self-managing of one’s illness, whether recurring symptoms are at that point in time present and working towards a self-caring, independent and fulfilling life. The definition of a satisfying like varies from one individual to the next. This is why each consumer’s recovery journey is personal and tailored to fit their goals and beliefs (Serafín Lemos-Giráldez 2015).