Substance Abuse Case Study

The National Center on Addiction and Substance Abuse provides guidelines and recommendations to healthcare providers in terms of how to screen for an addiction. Opioid addiction is screened primarily through patient interviews involving both specific and open ended questions about their lifestyle, mood, and drug use. A psychiatric exam may also be administered to look for psychological factors indicating an addiction such as depression, anxiety, and other psychological symptoms related to addiction and withdrawal. Withdrawal is evaluated by gradually taking a patient off opioids and if symptoms of withdrawal are found the severity of the withdrawal itself is then evaluated.2 If a patient is diagnosed with an addiction to opioids then the transition to tertiary prevention, or treatment will occur. However, treatment will only occur if early detection and screening techniques are utilized fully by healthcare provider otherwise it is likely an overdose will kill the opioid

Opioid dependence in the United States is increasing in numbers with those addicted to heroin and prescription opioid analgesics. Opioid use includes morphine, codine, oxycodine, the painkillers oxycodone, hydrocodone, fentanyl, and heroin. Several different treatment options are available for opioid dependence. Behavioral therapy includes counseling, cognitive therapy, phychotherapy, and the twelve step recovery program developed by Alcoholics Anonymous. Prescriptions can also be used for the treatment of opioid dependence. For example, methodone is used to help treat heroin abusers, and buprenorphine is used to treat opioid dependence, more specifically, Suboxone.

Today the recent growth of prescription opioid painkillers has made opiate use far more domesticated and widespread than ever before.  Even though heroin use has declined, the use of prescription opiates has increased. The use of prescription opiates for people who are dependent on the drugs for pain reduction has lead to an increase in abuse. When a family member or friend begins taking the drugs, not because they need them, but because they want to feeling, it becomes an addiction. Even though an addict is dependent on opiates, a person who is opiate-dependent is different because of the psychological, physical, and financial effects.

The pharmacological treatments are methadone buprenorphine (subutex) , buprenorphine and naloxone (suboxone), naltrexone. There are also many opioid reversal agents used to reverse the effects of opioid intoxication such as naloxone (narcan) given as iv/im/sc by healthcare providers. It is also available as an autoinjector im/sc to be used at home by families. The behavioral therapies used to stop an opioid addiction are Cognitive Behavioral Therapy, Motivational Incentives, Motivational Interviewing and Group Therapy. These therapies might include addressing a patient’s motivation to change their ways, provide them incentives to stop taking drugs, help them build a resistance to drug use, replace their drug using activities with constructive and rewarding activities, help them improve their problem solving skills and help them build better personal relationships. The best way to help an addict is to educate them. The education has to follow certain criteria such as let the patient know that they will not be able to use the substances in a controlled fashion, The treatment alone is hardly ever successful so they need to go to rehabilitation to get a full recovery. Their own willpower will not help them and that they need to go to Narcotics Anonymous, that recovery is possible and many have succeeded, that after a relapse they can still stop the

Opioid Use Disorder (OUD) is a chronic and potentially life-threatening disease, and the main feature of which is addictive and compulsive opioid use (Drugs & Crime, 2010). Opioid drugs include some of the prescribed pain relievers as well as illicit drugs, such as heroin, codeine, oxycodone, etc. In the United States, about 9.5 million adults use pain relievers for nonmedical purpose, 1.6 million adults meet diagnostic criteria of pain reliever use disorders, and 0.56 million have heroin use disorder (Hedden, 2015), at a huge social and financial cost (Alan G. White et al., 2011). Furthermore, the relapse rate of OUD patients in treatment is high (Davstad et al., 2007).

On Saturday May 19, 2018 at approximately 3:50 p.m. I observed a yellow Ford Escape traveling north on U.S. 19 approaching Grand Blvd bearing what appeared to be an expired tag of BFZW56 dating 06-2017. A check of FCIC / NCIC confirmed the tag was expired as of 06/22/17.

To begin, opioid abuse and addiction have increased in frequency in the United States over the past 20 years.4 In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200000 used heroin, and approximately 9.6% of African Americans used an illicit drug.4 Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders.4,7 Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction.4 Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings.5,6 Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings.4 The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders.4,11

Michael Doe is a 21 year old methadone patient. He presented at a Methadone Treatment Center with a 3 year history of opioid prescription use (egg. Percocet).

Everyday more and more treatment options and medications are being used to help to combat the world of drug abuse and addiction. According to the CDC about 980,000 people in the United States are abusing some form of opiates, weather it is pills or heroin. One of the newer trends of treatment that is now being used and growing rapidly is Medical Assisted Treatment (MEDICAL ASSISTED TREATMENT). As with any treatment or medication therapy there are the medical benefits and also the medical downsides. Medical Assisted Treatment was intended to help prevent people from continuing their drug abuse, but is now not only helping people but is also turning into an abused drug itself. ‘

On 08/12/15, Mr. Harrison’s mother reported that Mr. Harrison was not living at his reported address (104 Hudson St, Clayton DE 19938). Mr. Harrison mother stated that Mr. Harrison is living in Wilmington, DE with a friend. She could not confirm the address. Mr. Harrison has failed to report his new address with 72 hours.

Mr. Landaverde reported that he does not have any medical illnesses and has not been prescribed any medications. Mr. Landaverde reported that he went to the doctor in August 2016 for a regular checkup. Mr. Landaverde stated that he normally goes to the doctor every six months. Mr. Landaverde reported that he has never been hospitalized in the past. Mr. Landaverde reported that he does not have any emotional or psychiatric problems. Mr. Landaverde stated that he has never been to counseling. He stated to the best of his recollections, neither one of his parents have ever suffered from a substance related disorder.

Like the general population, the nursing profession is also plagued by the growing problem of prescription drug abuse. The stressful work environment, the ease of access to prescription drugs and perhaps a lack of training or education adds fuel to the problem of addiction. According to the American Nursing Association about 10% of the nursing workforce may be dependent on drugs or alcohol (Starr, 2015). There are roughly 4,148,730 active nursing professionals in the United States (Kaiser Family Foundation, 2017). This means that around 414, 873 of nurses suffer from the aforementioned addiction issues. Since nurses are at the forefront of health care, it follows that any form of abuse causes a significant problem in the quality patient care delivery.

Severity of opioid withdrawal both at baseline. Use of ancillary medication for symptomatic relief during detoxification

On 10/29/2017 at 1837 hours, I was dispatched to 200 Ogden Rd. Apt A, for a report of an unwanted person; however, the male left the residence prior to my arrival. Upon my arrival, I spoke with Carmella Rome-Giannone.

Mr. Boyd reported in October of 2013, Ms. How-Boyd became a United States citizen. He stated that she said “now that I am an American, I can marry any undocumented alien, so they may obtain a green card”. Mr. Boyd stated that it was clear she no longer had any use for him. He stated that the tension grew in the home. He indicated that he believed Ms. How-Boyd was intentionally trying to “annoy him”. He stated that Ms. How-Boyd would arrive home as late as 4:00 a.m., and come into the home slamming the front door and being rambunctious. He indicated that the mother did not seem to care that the noise was affecting Annick as well. He stated that the child complained that she would sometimes fall asleep in school, because of the noise the mother was making. He reported that Ms. How-Boyd would often remove Annick out