Relapse Case Summary

In relation to drug abuse, relapse is resuming the use of a chemical substance or drug after a period of abstinence. The term can be said to be a landmark feature of a combination of substance abuse and substance independence. The propensity for dependency, repeated use, and tendencies that take the form of the substance being used, are some of the issues that drug users’ experience. Substances that enhance most severe tendencies in users and pose high pharmacological efficacy, are those that are cleared quickly from the body, in addition to those that bring out the highest tolerance. There can be increased substance tolerance with the increasing dependency in relation to drug in question,

D- The patient arrived on time for her session and reports being stable on dose and haven't used any illicit drugs. This writer advised the patient that this writer was in fact in receipt of missed phone call about coming to the session at 10:30 am rather than 10 am due to her mother in the process of selling the house. This writer addressed with the patient about letter from CHR from her counselor, Jade Bray stating about the patient non-compliance with her appointment due transportation barrier. According to the patient, she is going through hardship as her mother is no longer taking her to her appointment as the patient says, " She's tired of bringing me everyone, Charlene. She complains about bringing me here and does not understand why I can't even get a bottle...:Like c'mon. What do I have to do?" This writer explained to the patient about TEAM decision, at which the patient disagree with the decision. This writer asked the patient about her "judgement." According to the patient, she feels she is making judgement by not engaging any further altercation with patient at the clinic, dosing daily, coming to her counseling session, and trying to get help from Chrysalis for

The patient is a 34 year old black male. The patient reports he is single with 3 daughter ages 3, 11, and 13. The 3 year old live with him. He reports currently live with his mother and brother. The patient reports he has 14 years of education however has not received his degree. The patient reports being on probation for Injury to a child for the next two years. The patient is scheduled to be complete his probation in September 2016. The patient reports Cannabis is primary substances and his last use July 20, 2015. He stated on that day he smoked about 5 joint. The patient also report that he tried Xanax . 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 Thursday, July 30, 2015 at

Counselor flagged Pt. on the AMS computer system to meet with this writer before dosing. Pt. met with counselor discussed and completed an AMS Dose evaluation to increase her dosage of methadone because she isn’t feeling well and experiencing side effects. Counselor prompted Pt. to talk about her pregnancy, medical appointment and to schedule her monthly therapy session with this writer. Pt. reported that her pregnancy is going well and she is having a lot of appointments at the Bay health hospital in Dover, DE. Pt. stated that they can’t determine the baby sex because her baby has the legs cross. Counselor told pt. that the Bay Health Hospital has a good nicu care unit and professional doctors. Counselor asked Pt.is

3. The patient had informed this writer initially of his goals of wanting to return back to the Hartford Dispensary due to the length of time he has been with the clinic and his positive rapport with his prior counselor at the other facility. The patient was compliant with his individual sessions with this writer and provided cancellation if unable to attend the session in the meantime while he awaits on the process of completion with his intake at Hartford Dispensary.

D-This writer met with the patient as he was placed on HOLD to address the status of the IOP. The patient provided this writer a paper that was provided to him with listing of IOP for him to explore. The paper shows scribbles of the patient taking down notes about his attempts of who he called. The patient reports Connecticut Addiction Recovery will call him back within 24-48 hours. The patient was able to schedule an appointment with New Direction for May 20th at 7pm; patient spoke with Dan. This writer commends the patient for all of his efforts; however, the patient needs to schedule something earlier than May 20th. This writer asked the patient about ICRC-Coventry House. According to the patient, he called the contact number and showed proof. The patient reports that ICRC gave him two different number and told him to do a walk-in at 8:30am. This writer shared with the patient about a recent conversation this writer had with ICRC. This writer told the patient

The patient was placed on HOLD to see the writer to address his non-compliance with treatment. The patient was reminded about his Step 3 of the patient engagement. According to the patient as the writer reviewed the patient case history of his no show for counseling, group attendance, and continuously AWOL, the patient only response was, " I, know." The writer then inquired of the patient efforts to engage in mental health services through ICRC. The patient admits that he haven't done the intake when the deadline was extended for the third time. The writer discussed with the patient about the risk of facing an intent to discharge due to his non-compliance and addressed alternatives such as suboxone and transferring to a clinic in Massachusetts to accommodate the work location. The patient declines the writer's suggestion as he wants to remain with HCRC-Hartford due to the positive treatment and said. " You guys really care....I do not want to be discharge.....I, mean what is the process of the intent of discharge?" The writer explained to the patient about the appeal process as his record will be reviewed by the Practice Manager to determine as to whether or not to forward with the discharge or the discharge to be overturn.

D-Met with the patient as she placed on HOLD due to recent concern of her overall well-being reported by Nurse Frank as he reported to this writer yesterday of his concerns that the patient's boyfriend is refusing her to increase on her methadone due to an agreement and the patient tends to appear emotional. Upon meeting with the patient, the patient immediately knew why she is meeting with her and started to get emotional. Denies feeling SI/HI. According to the patient, she had an agreement with her boyfriend of which she agreed to increase her dose up to 55mgs as her boyfriend will closely monitor her recovery. The patient does not feel unsafe around her boyfriend as she reported. This writer strongly advised the patient that she has rights to her own recovery process because it's her in the recovery and seeking treatment, at which the patient agreed. But says, "I am fine with my current

D-The patient was advised that her bottles are in fact suspended due to the incident that occurred on 02/08/2017 of which the patient needs to accountability of taking a second dose of her methadone even though she has taken her methadone at home. The patient admits her accountability of her actions of taking the second dose. The patient then asked about how she can regained her take home bottles of which this writer explained the policy of take home bottles, referring to the reinstatement process. The patient is referred to attend the Take Home Bottle Group on 03/9/2017 to have her bottles reinstated. Then the patient shared that she wrote a grievance letter and still plans to submit it for the Program Director to review. Furthermore, this

Supervisor Comments: This writer met with Cherron to address some concerns of what is patients on his caseload have reported and their request to be reassigned. Please note, there was a previous conversation with Cherron yesterday about patient #9100 and #2693 as Cherron reports of the two patient non-compliance with keeping appointments referring to counseling sessions. In addition, Cherron shared some concerns about patient #2693 ongoing use of illicit benzos/cocaine and the need to seek a higher level of care. This writer informed Cherron that patient #9100 admits to his non-compliance with his appointment; however, often finds it difficult to reschedule with Cherron due to Cherron lack of response of his request. In addition, the patient felt disrespected of Cherron refusal to meet with him on 3/13/2017.

For my relapse prevention research paper, I wanted to choose a substance/individual combination which would be convoluted, devoid of a simple or straightforward treatment plan. Due to my interest in healthcare, I decided to address an increasingly prevalent issue in the field, substance dependence to clinically-prescribed opiates. According to the National Survey on Drug Use and Health (NSDUH), the number of opiate prescriptions written in the United States has skyrocketed over the past two decades. In 2013, the United States Department of Health and Human Services reported that there were an estimated 1.9 million illicit opiate users in the United States who were either abusing or dependent prescription pain

According to the National Institute on Drug Abuse, the relapse rate is 40-60%. Not only do we need better alternatives to recovery for alcohol and drug addiction, but we must lower the relapse rate. In order to successfully lower the relapse rate we must inform people on the effect gateway drugs can have on future addictions, educating about relapse and addiction and focusing on key factors to making a treatment a successful one. My research on lowering relapse rates taught me that the problem is not getting sober, its staying sober.

Many people who are able to successfully get off of a substance that they were once addicted to end up suffering a relapse. The good news is that if one knows the common relapse triggers, then he or she will have an easier time avoiding them. Below is a list of some of the common relapse triggers and what you can do to avoid them:

Being able to identify these stressors, and high-risk situations, serves to provide needed insight that guards against potential relapse. Relapse prevention programs go further, equipping the patient with the needed tools and skills that they can use to disarm the stressors and resulting triggers that cause emotional and mental disturbance. Relapse prevention programs also contain aspects of improving physical health, as overall health, mind and body, is indicative of a greater chance of long-term recovery. This is why supplemental therapies such as yoga, art, and music are important. These participatory therapies help the patient to express themselves, have an outlet for their thoughts and energy, and get practical experience in the ways to calm themselves, and head-off

DATA: Today’s group has been facilitated by Kirsten again, and includes relapse, what it is, and how each client can prevent it. Being that relapse is a process, it is an ongoing situation that can be interrupted, rather than a static event that is over and cannot be changed. It involves the individual reverting to old attitudes, beliefs, values, and risk behaviors. These are part of a progressive pattern, and will worsen until the process is interrupted or changed. Relapse is not a sign of failure, and, at times, may be part of the recovery process. There are times when individuals are more vulnerable to relapse, specifically, when they are too hungry, angry, lonely, or tired (HALT), and need to be aware of this vulnerability, and take