Jeff's Vignette Case Study

Mr. Turner exhibits signs and symptoms of chemical dependency. He has loss of control of his alcohol and other drug use, increased tolerance, drug cravings, absenteeism from work, and a family history of alcoholism. Occasionally, he experiences a down mood, loss of interest, and fatigue when he feels overwhelmed by his many responsibilities. Therefore, Turner has a chemical dependency.

Assessment and DSM MIDTERM Marilyn Lewis SSWG 8824 May 10, 2016 Jesse Timmons Assessment and the DSM Case Study 4 – Mr. Matthew Tucker Matthew Tucker is a 45 year old Caucasian male whose profession is a plumber. His family asked him to be evaluated by a psychiatrist after meeting and determining that he had an alcohol problem that was getting out of hand. He told his family that he had not drank any alcohol since his appointment was scheduled with the psychiatrist (Timmons, 2016). According to the DSM 5, Mr. Tucker meets the criteria for Alcohol Use Disorder/Alcohol withdrawal.

This section, using the DSM-5, has determined Frank has met the criteria for a moderate Alcohol Use Disorder (AUD). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2013) outlines anyone meeting any two of the 11 criteria’s under the DSM-5, within the same 12-month period would receive a diagnosis of AUD. The severity of an AUD, mild, moderate, or severe, is based on the number of criteria met (NIAAA, 2013). The presence of four to five symptoms would indicate a severity of moderate AUD (NIAAA, 2013). Based on Frank’s story shared in sessions, the therapist has determined that Frank has met five criteria’s of the DSM-5. Below are the specific DSM-5 criteria’s the therapist used to make this determination:

The Diagnostic and Statistical Manual V (DSM 5) describes the essential feature of a substance use disorder as a cluster of cognitive, behavioral and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. Specifically, the DSM V describes diagnostic criteria as a problematic pattern of alcohol use leading to clinically significant impairment or distress. Mr. Holliday manifested the following:

Stage 3: Major organ change – alcohol has done measurable damage to the body. Major Organ Changes • Maintenance use • Multiple drug addiction • Change in tolerance • Migraines/vomiting • Mood disorders/ paranoia • Insomnia • Suicidal ideation/attempts • Impotence • Delirium tremens • Night sweats • Compulsion/use despite consequences • Longer more frequent duration of memory loss • Major organ damage. Outside influences Loss of job/family/school

Risk level: Due to short length of sobriety, lack of support network and relapse prevention plan, and current emotional issues, risk level is 3.

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

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

Substance abuse is a diagnosable health problem, but often viewed as a moral failing which can compound the issues of people seeking services for sobriety (Bland & Edmund, 2005). Substance abuse can also cause reduced inhibitions, clouded thought processes and lesser abilities to access threats which may cause a person to miss the warning signs of an abusive person. While they may lessen the self -protective instincts of victims, the side effects of substance abuse are often noticed by manipulative

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

Substance abuse including drugs, alcohol, or both is combined with an area of devastating social conditions, including family separation, financial problems, lost capacity, failing in school, domestic violence, child abuse, and crime. Furthermore, both social characters and legal responses to the use of alcohol and drugs make substance abuse one of the most complicated public health issues. Understanding these aspects is key to lowering the number of people who

This data builds the precision of the substance use/abuse assessment, and additionally giving important course to setting up pertinent intercessions. The SALCE evaluates the activity in the client life by two ways; the normal assessment of life conditions which is reflected by one of the four classifications below. The other is to recognize regions of stress which are recorded under Low or Unusual Life Circumstance Ratings toward the finish of the SALCE report.

     ?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.

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).