Illicit Opiate Use Goal

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

If you have been working in EMS for longer than a week you will probably already know the epidemic that America is facing. The epidemic that I am referring to has no discrimination and anyone can fall victim to it. If it hasn't already destroyed your family in some way then you are one of the lucky few.

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.

D-Met with the patient as the Women's Group was cancelled due to low attendance. This writer addressed with the patient about her AWOL status, at which the patient started to get emotional as she is struggling with transportation, borrowing her mother's car, her husband is still having issues getting into the Hartford Dispensary-tested postiive for methadone, and too much stressors in her life, which is causing the patient to not eat. This writer validated the patient's feelings, provided support, and made suggestions. The patient admits to relapsing yesterday by purchasing 10 bags of heroin, but using 6 and gave her husband 4 bags-use of method was IV. The patient feels guility of using, but her stress factors are overbearing her recovery process and the patient struggles with coping. She then says, " When I come to the Women's Group, I feel good....I was hoping there was going to be group today....I don't know." This writer provided empowerment and encouragement to the patient to focus on her recovery process and proceeded to discuss risk factors of what she will lose.

Objectives/Progress: As the Pt. has participated in the AMS program since 8/24/16 and he has been able to maintain abstinence from all illicit drugs for 6 months straight t. Pt.'s UDS has shown no evidence of drug use or lapse/relapse. Pt. is currently in the action stage of change as indicated by reminding himself of how much progress he has made and ability to change his behavior and achieve goals during the past quarter. He has currently obtained a full-time job as a shelving installer. Patient reports as scheduled to receive maintenance medication services as instructed by AMS Doctor and attends all mandatory one therapy session once a month. He continues to share his understanding of being powerless and unmanageable over his addiction. During the next quarter sessions, Counselor will support a realistic view of change through small steps.

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.

D-The patient arrived on time for her appointment. Reports stable on her dose and denies the need for a dose increase when offered by this writer. This writer commends the patient complying with daily dosing; however, this writer addressed the patient UDS result patterns of positive and negative. The patient last two urines were positive for cocaine. According to the patient, a lot has been going on in her life. The patient's father has had a heart attack this past month. Also, the patient has an estranged relationship with her mother and her 17 year old daughter. During the course of the session, the patient discussed her drug history and her dysfunctional family. Alternatives and suggestions were discussed as well.

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.

The social problem I chose to do something about is opiate abuse/addiction. Opiates are naturally occurring narcotics, such as opium and opium derivatives, including morphine, codeine, and heroin. Prescription painkillers are opioid analgesics. Opiates are highly addictive and dangerous when misused. This social problem matters to me because I am a recovering opiate addict. I have been clean for four months and my new found passion is educating people about the dangers of opiates. People assume because doctors prescribe opioid analgesics, they must be safe. Opiate abuse matters to society because when opiates are misused, lives are taken. People die from overdose, abusers’ worlds fall apart because of their addiction, and loved ones of the abusers are left grieving and feeling helpless.

When people picture a drug addict, many individuals may see the same picture of a dirty, disgusting, maybe even homeless, individual that has no place in this world. While addicts like this do exist, the wide spread of the current opiate addiction crisis has completely changed the worlds perception. The word opiate is a wide spread term for a group of narcotics that cause sedation, respiratory failure, and if used excessively, can result in death. However, their high potential for addiction has resulted in what some parts of the world have declared as a public health crisis. With the over-prescribing of painkillers and the increased availability and lowered price of heroin on the streets, opiate addictions and overdoses have increased dramatically;

Patient states that he was on unit in April of this year. Patient states that after discharge he tried to get into a program (Salvation Army in Manhatten), but there were no beds available. Patient reports that he went back to his same enviromemtn, Jersey City and started drinking and using heroin. Patient said that he had no health insurance so he was unable to fill his prescription. Patient reports that he applied for Medicaid and is currently waiting to see if he is going to be approved. Patient stated that he would like to go to Meadowview in Seacucus. Patient states that he reason why he uses is to self-medicate because he has no insurance. Patient stated that he would like to get into long-term rehab that does not require him

D-The patient received his dose increase today from 35mgs to 40mgs. According to the patient he was doing okay at 35mgs, but feels 40 mgs will do better. The patient admits to using heroin last night, 2 bags by IV. This writer stated he did not use due to cravings, but to help him sleep as he going through withdrawals. The patient further believes with the new dose, he will be able to sleep better at night. This writer then asked the about the outcome of his blood works with Brownstone Clinic. The patient then admits that he hasn't follow up because he did not have any minutes on his phone, but will follow up today and update this writer during the next scheduled session. This writer then proceeded to discuss with the patient about his goals for his treatment during the remainder of the session.