Jeff's Vignette Case Study

To be diagnose with substance use disorder the person will have the following symptoms that has occurred during a 1 year period. The inability to manage key obligations at home not paying mortgages and bills, work not showing up or missing important deadline or school not going. Driving while under the influence which could cause physical harm and hazard to yourself and others, social and personal issues because of substance use, legal problems because of substance use disorder.

Substance abuse is a key component to the problems that we face today as a society. According to the National Highway Traffic Safety Administration ("Alcohol-Impaired Driving", 2009) in 2009, 32% of all motor vehicle traffic fatalities in the United States were due to alcohol-impaired driving crashes. Surveys were also conducted by the National Highway Traffic Safety Administration (National Highway Traffic Safety Administration, Compton, & Berning, 2009) so researchers were able to estimate not only the prevalence of drinking and driving, but for the first time they were also able to collect data on the number of drivers who were under the influence of drugs that impaired their abilities. In this data, it was found that 16% of weekend night time drivers tested positive for impairing drugs, in contrast to the 2% of drivers who were at the legal alcohol limit; making drugs 7 times more prevalent. These statistics show that “drugged” driving is a concern for not only law enforcement but also puts other drivers at risk of becoming a part of future statistics.

The definitions have progressed from tolerance or withdrawal symptoms from a specific drug to chronic intoxication, continued use with increased dosage, dependence, and damaging effects to user (Reinarman 2005). Both of these definitions proved to be too restrictive because all drugs do not have the same effects on every user. The current definition used by physicians and the criminal justice system is based on seven criteria (Reinarman 2005). The constant evolution of how the professional world views drug dependence mirrors society’s change in the understanding of addiction. Historically, “the drink” was viewed as the devil and drugs were often thought to be the cause of many criminal acts (Schneider 2003). After the medicalization of addiction and dawn of decriminalization of drug abuse, public opinion of deviant alcohol and drug use has changed. For the family unit, it is much simpler to accept and approach treatment for addiction if it is classified as a medical disease. In society, drug users can be framed as patients instead of criminals based on current standards. By looking at addiction as a treatable set of signs and symptoms instead of holding the individual accountable for actions they committed while intoxicated, the disease concept releases a lot of the stigma that goes along with

Jed, a 38 – year old welder, enrolled in the treatment center after his arrest resulting from drunken driving (DUI/DWI) (National Institute on Alcohol Abuse and Alcoholism, n.d.). His lawyer has advised him to stop drinking and get treatment until his trial date, which is in approximate two months. Jed does not believe that he will serve any jail time, but feels that treatment could help strengthen his court case (National Institute on Alcohol Abuse and Alcoholism, n.d.). In this paper, I will create a relapse prevention plan that will aid Jed as he enters into his treatment program. This paper will also show

The DSM–5 incorporates the two DSM–IV syndromes, alcohol abuse and alcohol dependence, into one disorder - alcohol use disorder (AUD). AUD has sub-classifications of minor, moderate, and severe. A person who meets one or more of the criteria for abuse within a 12-month period would receive the “abuse” diagnosis. Anyone with three or more of the “dependence” criteria (see items 5 through 11) during the same 12-month period would receive a “dependence” diagnosis ( American

As clinicians, there is a duty to provide as clear of a diagnostic assessment as possible, particularly in relation to substance use, in order to provide the best care. In Substance Abuse Counseling: Theory and Practice, the authors state “as with other diseases and disorders, the earlier a therapist diagnoses a substance abuse problem, the better the prognosis for the client.” (Stevens & Smith, 2013) This makes assessment crucial to the diagnostic process. In “Screening, brief intervention, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple heathcare sites,” written by Madras, Compton, Avula, Stegbauer, Stein, & Clark (2009), the reported 2006 NSDUH survey statistics estimated that “22.6 million people harbor a diagnosable alcohol or illicit drug use disorder.” (Madras et.al, 2009) Over the years, researchers have developed

People seem to get the wrong impression that alcohol is classified as a stimulant or “upper”, but in actuality alcohol is a depressant. The short term physical effects depend on the blood-alcohol level. It ranges from random changes in mood to complete lack of coordination, impaired vision, lack of balance and slurred speech. However, larger amounts of blood alcohol can strongly effect brain functioning and eventually cause a person to “black out”. In examining the thought process for drinking and driving behavior, Kulick and Rosenberg (1999) found that while the majority of their college student sample frequently drove after drinking, these students rationalized this behavior in a variety of ways. The most commonly found reasons for driving under the influence of alcohol were the strong desire to get to a specific destination (e.g., home), convincing oneself as being only slightly intoxicated, and/or believing

Alcohol abuse is growing rapidly throughout U.S. society. One in every twelve adults is being diagnosed with alcohol abuse (Barlow and Durand, 2006). All that are diagnosed with alcohol abuse must meet one or more of the following criteria within a twelve month period: he/ she must fail to accomplish major work, school or home

     ?Alcohol?s effects are progressively more noticeable as the blood alcohol concentration increases. At a BAC of .02 to .05 percent the effects are almost entirely pleasurable. The drinker feels relaxed and sociable. There may also be some modest impairment of reasoning or memory and general reduction in caution. A BAC of .05 to .07 produces a state of excitement. The drinker begins to suffer from what may be a slight but nonetheless noticeable impairment of balance, speech, vision, reaction time, and hearing. Judgement and self-control are also effected. The driver?s behavior is apt to become more aggressive. In general, the drinker feels stimulated and highly capable. In reality his or her ability to safely perform tasks such as driving that require quick reactions, concentration, and good judgement has been significantly reduced.

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

“A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring

Relaxation, celebrating, and socializing are often reasons people engage in alcohol. However, the enjoyment of alcohol in moderation may become difficult for some individuals to manage when using alcohol as coping mechanisms or scapegoat, for other underlining issues: personal, social and work-related concerns. Unfortunately, lack of proper management may or can result into alcoholism. According to the DSM-V alcoholism is diagnosed as alcohol use disorder or alcohol addiction, in which a person becomes physically and psychologically dependent on alcohol to the point that he or she cannot function without it (American Psychiatric Association,2013).

According to the data from U.S. Department of transportation, about 1.5 million drunk drivers are arrested every year. In response to an annual national survey conducted by the Bureau of Justice, in which the sample was offenders serving jail terms for various crimes committed; 36% of the offenders indicated that they committed their crimes under the influence of alcohol or drug (http://bjs.ojp.usdoj.gov). This percentage accounts for nearly one million of convictions carried out yearly. However, there are some variations in substance abuse among state and federal offenders.

Alcohol dependence is known to be the most severe form of alcohol abuse. A person becomes so dependent on alcohol consumption that he/she loses sight of all the other important things going on around him/her. Family matters and social responsibilities become secondary worries to his/her primary concern for existence, which is drinking (Stephens, 2007). Nearly fourteen million Americans are somewhat dependent on alcohol. Alcohol dependence is more prominent in men, and young adults ages 18-29 (Stephens, 2007). According to a study done by Saitz “85,000 deaths, along with substantial disability from medical and psychiatric consequences, injuries and “secondhand” effects (ex: motor vehicle crashes) are attributed to the use of alcohol” (Saitz, 2005).

Long-term alcohol abuse produces physiological changes in the brain such as tolerance and physical dependence. Such brain chemistry changes maintain the alcoholic's compulsive inability to stop drinking and result in alcohol withdrawal syndrome upon discontinuation of alcohol consumption. Alcohol damages almost every organ in the body, including the brain; because of the cumulative toxic effects of chronic alcohol abuse, the alcoholic risks suffering a range of medical and psychiatric disorders. Alcoholism has profound social consequences for alcoholics and the people of their lives. Becoming addicted to alcohol is a gradual process that happens as alcohol changes the level of chemicals in your brain, especially gamma-amino butyric acid or GABA (which stops you from being impulsive) and dopamine (which is linked with pleasurable feelings). As the levels of these chemicals change, you crave alcohol to make yourself feel good again.