Ilicit Opiate Use Goal (S): To Become Drug Free Status

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.

The participant is a 49 year old African American male who began using substances at the age of 13. He was diagnosed with severe alcohol, cocaine, and opioid use. The participant has been incarcerated over the past 32 years. He was recently paroled after completing eight years of a sixteen year sentence in the Illinois Department of Corrections for burglary and theft. The participant is on medications to treat HIV/AIDS and has been diagnosed with Major Depressive Disorder. He was referred to Healthcare Alternative Systems residential program through TASC as a condition of his probation.

The counselor met with the patient for her scheduled Addiction Severity Index assessment. The patient is a 54 year old black male. The patient states he is single with no children. He report currently lives with sister in law of his decease brother. The patient reports having a 14 years of education however no degree. The patient report receiving disability for mental health disorder. The patient reports he is currently not on probation. The patient reports he last use Cannabis 7/17/15 and started using at the age of 13 and smokes 3 to 4 times a week at least 2 joints. He also report using Alcohol 7/20/15 a 40oz beer and usually drank a couple a day. The patient denies any issues with HI/SI. Patient also reports he is taking his medication as prescribed. The patient appear to be in the pre-contemplation stage of change. The patient next scheduled individual session with the counselor is on Monday, July 27, 2015 at 02:30p

Xavier then reported, the applicant recovery is up and down and the reason the patient was transferred and admitted to the Norwich location was due to an altercation as the Hartford Dispensary has zero tolerance for physical violence. Since May of of this year, the applicant's UDS results are negative. Last positive result was in April for cocaine, according to the counselor. Please note, during the applicant intake, he was asked about other illicit drugs and only confirmed for use of heroin and THC, not the cocaine. The applicant's current dose at the Hartford Dispensary is 105mgs as he is being detoxed daily. His highest dose was at 145 mgs before his detoxification. The physical altercation was the applicant's first behavioral incident at the clinic. He was also on a 90 Probation for his illicit use and it would have expired in August, but due to the recent incident, he was removed from the clinic, not discharged, but transferred as mentioned before. Counselor Xavier only concern of the applicant is maintaining his

will schedule an appointment to discuss and create a budget plan. Patient is currently free from all illicit drugs, which has helped her Adderall medication to be more beneficial. Primary Counselor will encourage Pt. to follow through with all mental health appointments. Counselor will prompt Pt. to develop a positive self-image. Pt. has denied having any auditory or visual hallucinations during the last quarter as evidenced by group and individual session notes. Pt. has had some setback in achieving her goals of decreasing her family conflicts and resolving intimate relationship issues. Counselor will encourage Pt. to attend the AMS parenting group and share her expectations regarding having a more functional family unit. During the next quarter therapy sessions, Counselor will utilize role-playing, role reversal, modeling, and behavioral rehearsal to assist Pt. in order to develop positive ways to resolve conflict with ex-husband. Pt.’s current treatment plan goals focus on opiate use disorder, financial, mental health services and parent-child relational problems. During the upcoming quarter, current goals will continue to be

Problem #5 Illicit opiate use Goal(s): To become drug free Status: Active Objectives/Progress: Pt. has not done well in achieving his goal of maintaining abstinence from all illicit substance use over the last quarter as evidenced by his positive UDS. Patient’s last urine screen results indicate that opiates have been used. Pt. reported that he was able to be clean from more than 30 days but he used drugs while walking through his neighborhood. Counselor expressed concern and disappointment about his recent relapse on heroin. During last month session, Pt. recognized the danger of the situation and how he will avoid the acquaintance that offered him drug. Pt. has failed to move to Phase 1 of the AMS of DE TX program due to his four positive UDS since entering the program on 7/6/16.Counselor will meet with Pt. to examine pt.'s motivation to stay clean, how to deal with triggers in order to achieve continued abstinence, to help him recover from his recent relapse and reenter the change process.

Client was considered to be in semi-compliance with treatment during this reporting period. Client attended two secheduled groups with two absences. UA were negative for all tested substances. Client reported participating in self-help meeting regularly; verification was provided. Treatment attendance needs to be improved in 30 days.

Pt. has been in the AMS program for 2 years. Pt. has had no positive UDS results for two years. Pt. is on a dose of 150 of methadone and he is responding as expected to his prescribed medication. Pt. demonstrated responsible attitude by attending monthly AMS groups faithfully. Pt. has discontinued all illicit drugs use and now he has used financial income in a more self-sustaining manner. Pt is effectively addressing this area by making regular payments as scheduled. Demonstrates treatment maturity and appropriately participating in medical treatment services. Pt. was taught calming strategies, such as relaxation and breathing techniques as indicated by previous counselor documentation. Pt. was assigned to this writer caseload and counselor

D-The patient reports he is not stable at his current dose to the point he want to taper off. He expressed the need to want to get off on methadone. This writer listened to the patient vent about issues in his personal life and problematic issues with his transportation to ensure he dose daily. This writer then proceeded to discuss with the patient as to why he had entered treatment, his aspiration for his recovery process, and addressing alternatives to his barriers. The patient then reports he hasn't used any illicit drugs for three days, at which this writer commended the patient. When asked about what strategies to used to refrain from illicit drugs, he reports keeping himself busy and continue to care for his parents. The patient was

The patient appears to be happy and focused on her recovery process. This writer discussed with the patient briefly about her treatment plan goals and also, briefly discussed tapering off methadone, at which the patient is willing to pursue but at a seldom pace. There was no evidence of

Today I visited a treatment facility in Dayton OH. On James H Mcgee Blvd. This is a methadone based facility that has more than 800 clients currently receiving a daily regime of methadone; this is an agonist substance used in the treatment of opiate addiction. My interview today is with Lakisha Russell, a Licensed Social Worker: she also carries a MHT degree and a LCDC III. Furthermore acquiring a portion of this education at Sinclair.

Objectives/Progress: As the Pt. has progress in tx, he reported increased financial stability during groups and brief IC sessions. He is currently able to sustain his OTS and personal needs with his full-time job as a real estate appraiser. Also, Pt. has become more financially secure and demonstrate responsible behavior as evidenced by saying no to one's impulses.

The client stated that due to his addiction, he would place himself in dangerous situations. The client has been able to identify previously unknown triggers that lead to relapse. For example, the client stated that he would drink large amounts of alcohol because it "wasn’t my drug of choice". The client soon relapsed on his drug of choice. The client stated, "I never thought about why I relapsed before". The client expressed the importance of aftercare to maintain long-term sobriety. The client attends weekly AA/NA and Big Book meetings in the PWC ADC. The client will continue to work on identifying and developing healthy coping skills, learning and building an awareness of triggers, understanding the importance of aftercare, and working on a relapse prevention

D- The patient arrived on time for her counseling session. Reported unstable on her dose and accepted a dose increase of 5mgs as she is still experiencing withdrawals and cravings. The patient admits to using illicit drugs recently- heroin-5 bags by inhalation, cocaine-a couple of lines by inhalation, and smoke a couple of days of THC. Alternatives were discussed, which led to a discussion about the patient's treatment plan goals. The patient reported that she has a hearing with SSA, referring to her Disability hearing on September 7, 2016.

Opiates are a commonly prescribed medication today in America. These powerful medications come from the poppy plant and are known to relieve pain. They fall into a class known as “narcotics,” which also includes other pain relievers. The term is often used interchangeably with the term “opioids,” drugs similar to opium. Regardless of what you call them, opiate addiction happens quite frequently.