Substance Abuse Treatment Analysis Essay

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The symptom of preoccupation is marked by an individual's tendency to spend a considerable amount of time thinking about, consuming, and recovering from the effects of the substance(s) of abuse. In some cases, the individual's behavior may be noticeably altered by his or her preoccupation with these matters. Such an individual may, for example, lose interest in personal relationships or may become less productive at work as a result of constant preoccupation with obtaining more of the substance of abuse.

Adverse Consequences

Examples of adverse physical consequences resulting from AOD abuse include experiencing blackouts, injury and trauma, or withdrawal symptoms or contracting an infectious disease associated with high-risk sexual behaviors. One of the most serious health threats to AOD abusers, particularly those who inject drugs intravenously, is infection with human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS). Adverse psychological consequences arising from AOD abuse include depression, anxiety, mood changes, delusions, paranoia, and psychosis. Negative social consequences include involvement in arguments and fights; loss of employment, intimate relationships, and friends; and legal problems such as civil lawsuits or arrests for abuse, possession, or selling of illicit drugs.

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TOPIC: Essay on Substance Abuse Treatment Analysis of Assignment

Making a mental link between one's use of AOD and the problems that result from it - such as difficulties in personal relationships or at work - is an important step in recognizing one's AOD abuse problem. Some individuals who have experienced negative consequences resulting from their AOD abuse will report these problems during a screening assessment. Clients who show insight about the relationship between these negative consequences and their use of AODs, should be encouraged to seek help. Many, if not most, people who abuse AODs, however, do not consciously recognize that they have a problem. Other reasons why a person may not disclose an AOD abuse problem include denial, lack of insight, and mistrust of the interviewer. These individuals cannot be expected to respond affirmatively to "transparent" problem recognition items - those in the form of direct questions, such as "Do you have an AOD problem?" - during a screening interview. For these individuals, questions must be worded indirectly in order to ascertain whether negative experiences have ensued from the use of AODs.

Tolerance and Withdrawal

AOD abuse, particularly prolonged abuse, can cause a variety of physiological problems that are related to the development of tolerance and withdrawal. Tolerance is defined as the need to use increasing amounts of a substance in order to create the same effect. If tolerance has developed and the individual stops using the substance of abuse, it is common for withdrawal effects to emerge. Withdrawal from stimulants and related drugs often includes symptoms of depression, agitation, and lethargy; withdrawal from depressants (including alcohol) often includes symptoms of anxiety, agitation, insomnia, and panic attacks; and withdrawal from opiates produces agitation, anxiety, and physical symptoms such as abdominal pain, increased heart rate, and sweating.

Source: Adapted from Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and Infectious Diseases. Treatment Improvement Protocol (TIP) Series, No. 11. Center for Substance Abuse Treatment

As noted above, the selection of the AOD screening instrument is based on its known reliability and validity across the five domains as described further in Table 3 below.

Table 3

Sources for Items Included in the AOD Screening Instrument

Question No.

Source Instrument

Domains Measured by the Instrument

1

Revised Health Screening Survey (RHSS)

This question is designed to help delineate an individual's consumption pattern (the frequency, length, and amount of use) as an important marker for evaluating whether the client has an abuse problem.

2

Michigan Alcohol Screening Test (MAST)

This question is designed to identify symptoms of preoccupation and loss of control (preoccupation refers to an individual spending inordinate amounts of time concerned with matters pertaining to AOD use; loss of control is typified by loss of control over one's use of AODs or over one's behavior while using AODs).

3

CAGE

This question is designed to identify symptoms of preoccupation and loss of control as defined in question two and Table 1 above.

4

MAST, CAGE

This question consists of a series of problem recognition items that ask about past contacts with intervention and treatment services which can be a valid indicator of AOD abuse problems.

5

History of Trauma Scale, MAST, CAGE

This question is designed to elicit adverse consequences of AOD abuse including physical, psychological, and social domains; in addition, this question is aimed at determining whether an individual has experienced any of the signs of tolerance and withdrawal.

6

MAST, Drug Abuse Screening Test (DAST)

This question is designed to elicit adverse consequences of AOD abuse including physical, psychological, and social domains.

7

MAST, Problem-Oriented Screening Instrument for Teenagers (POSIT)

This question is designed to elicit adverse consequences of AOD abuse including physical, psychological, and social domains.

8

MAST, DAST

This question is designed to elicit adverse consequences of AOD abuse including physical, psychological, and social domains.

9

MAST, DSM-II-R

This question is designed to identify symptoms of preoccupation and loss of control as defined in question two above; in addition, this question is also designed to elicit adverse consequences of AOD abuse including physical, psychological, and social domains.

10

POSIT, DSM-III-R

This question was formulated in order to help delineate an individual's consumption pattern (the frequency, length, and amount of use) as an important marker for evaluating whether the client has an abuse problem; in addition, this question is aimed at determining whether an individual has experienced any of the signs of tolerance and withdrawal.

11

POSIT

This question was formulated in order to help delineate an individual's consumption pattern (the frequency, length, and amount of use) as an important marker for evaluating whether the client has an abuse problem.

12

POSIT

This question is designed to identify symptoms of preoccupation and loss of control as defined in question two above; in addition, this question is also designed to elicit adverse consequences of AOD abuse including physical, psychological, and social domains.

13

MAST, POSIT, CAGE, RHSS, Alcohol Use Disorders Identification Test (AUDIT), Addiction Severity Index (ASI)

This question is designed to elicit adverse consequences of AOD abuse including physical, psychological, and social domains.

14

MAST, POSIT, CAGE, RHSS, Alcohol Use Disorders Identification Test (AUDIT), Addiction Severity Index (ASI)

This question consists of a series of problem recognition items that ask about past contacts with intervention and treatment services which can be a valid indicator of AOD abuse problems.

15

MAST, POSIT, CAGE, RHSS, Alcohol Use Disorders Identification Test (AUDIT), Addiction Severity Index (ASI)

This question consists of a series of problem recognition items that ask about past contacts with intervention and treatment services which can be a valid indicator of AOD abuse problems.

16

MAST, POSIT, CAGE, RHSS, Alcohol Use Disorders Identification Test (AUDIT), Addiction Severity Index (ASI)

This question consists of a series of problem recognition items that ask about past contacts with intervention and treatment services which can be a valid indicator of AOD abuse problems.

Source: Adapted from Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and Infectious Diseases. Treatment Improvement Protocol (TIP) Series, No. 11. Center for Substance Abuse Treatment

Two versions of the AOD screening instrument are available for use depending on the specific needs of the clinicians or social workers using them, as well as the abilities and willingness of clients to participate. In any event, both of these screening instruments have been designed to be administered in the form of an interview (Appendix A) or a self-administered version (as depicted at Appendix B) to clients who are perceived to be at risk of having a substance abuse problem.

Appropriate Diagnosis. The evaluation of the client using the AOD screening instrument proceeds in a step-by-step fashion:

1. The screening instrument begins with a question about the individual's consumption of AODs (question 1). This question is intended to help the interviewer decide whether to continue with the interview - if the response to this first question is no, continued questioning may be unnecessary.

2. Questions 2-4 are problem recognition items intended to elicit an individual's assessment of whether too much AODs are being used, whether attempts have been made to stop or control AOD use, and whether previous treatment has been sought. Answers to these questions may help the service provider understand how the individual thinks and feels about his or her use of AODs. People who later report negative consequences as the result of their AOD use but who nevertheless answer "no" to these problem recognition questions may have poor insight about their AOD abuse or may be denying the severity of their AOD problem.

3. Questions 5-12 were designed to determine whether an individual has experienced any adverse consequences of AOD abuse. These include medical, psychological, social, and legal problems that often are caused by AOD abuse and addiction.

4. Some questions are intended to elicit symptoms of aggression (question… [END OF PREVIEW] . . . READ MORE

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