iam replying to my peer’s post on substance use disorder

Week 4 Discussion: Care for a Client Diagnosed with a Substance Use Disorder

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2. My courses
3. NU-665C-06-23PCFA
4. Week 4: Substance Use Disorders (SUDS) and Addiction
5. Week 4 Discussion: Care for a Client Diagnosed with a Substance Use Disorder

Completion requirements

Done: Make forum posts: 1

Value: 100 points

Due: Create your initial post by Day 4 and reply to at least two of your peers by Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the following prompt.

Initial Post

For this discussion, address the following prompts:

• Elaborate on etiology, stressors, problems of addiction, dependence, and relapse in the United States today.
• Identify potential physical and mental findings when examining a client with a substance use disorder. Note your rationales.
• Describe possible triggers to compulsive substance use or behavioral addiction.
• Discuss the neurobiological mechanisms that underlie addictive behavior.
• What medication-assisted treatments (MATs) and psychotherapeutic interventions for monitoring (for alcohol and for opioid abuse) are available?

Use APA format with reference list (two to three books and/or articles).

Replies

Reply to at least two of your peers. In each of your reply posts, write a maximum of two paragraphs (with two to three sentences each). Describe what you would do differently than your peer. Also explain something new that you learned from your peers post. These paragraphs should synthesize one to two pieces of research.

Please refer to the Grading Rubric for details on how this activity will be graded.

The described expectations meet the passing level of 80%. You are directed to review the Discussion Grading Rubric for criteria which exceed expectations.  

I am replying to a peer’s post

Re: Week 4 Discussion: Care for a Client Diagnosed with a Substance Use Disorder

by Rebeca Gallego – Wednesday, 20 September 2023, 1:04 PM

     The DSM-5 defines substance abuse disorder into different categories or criteria types. They are separated into impaired control over substance abuse, social impairment, risky use, and pharmacologic. Each of these criteria have different definitions of how substance abuse is impairing an individuals health, functioning, and wellbeing. For example, Impaired control over substance abuse involves the individual having cravings and desires for the substance, spending a lot of time trying to get the substance or getting over the effects of the substance, and having a desire to stop using (McNeely & Adam, 2020). This is one way that addiction is defined and diagnosed.

     The etiology of addiction is multifactorial, and rates of substance use disorders in the United are very common, with 14.5% of those over 12 years old having a substance use disorder in 2022. These substance use disorders include alcohol use and illicit drug use (Dugosh & Cocciola, 2022). We will see these disorders a lot in our practice, whether they are current or recovered from their addiction it is something that stays with a person and shapes their lives. During assessment It is important to determine what type of substances have been used, the amount, and the frequency. Mental health disorders and substance use disorders are commonly comorbid, so if not done already it would be helpful to screen for depression, anxiety, and other disorders by diving into the patient’s family and social history (Dugosh & Cacciola, 2022).

     The risk of developing an addiction comes from social, cultural, environmental, stress, and trauma factors. These developments shape a person’s personality and how they will respond to things. Genetics play a big role as well, this being the reason that family history shoud be discussed. When a person is intoxicated by a drug, dopamine is stimulated and the reward pathway is strengthened. Some individuals experience this more strongly than others, and we must consider where a person comes from. If someone has a lot of pain and trauma, these rewards become even more intoxicating and work as an escape from their negative feelings. When these feeling wear off is when a craving will start, along with possible withdrawals depending on the amount and type of substance (Volkow et al., 2018).

     Early intervention types of care is recommended for those at risk for SUD and this can be done in emergency departments and primary care clinics. An example of someone who would benefit is one who is caught driving under the influence and would benefit from therapy and treatment for substance abuse. More intensive programs exist that are inpatient and assist patients with supervised withdrawal. They provide close monitoring and the proper medications to ensure safety (Hartwell & Brady, 2021).

References

Dugosh, K & Cacciola, J (2022). Substance use disorders: clinical assessment. Up to Date; Wolters Kluwer. Retrieved from: https://www.uptodate.com/contents/substance-use-disorders-clinical-assessment?search=substance%20abuse%20disorder&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Hartwell, K & Brady, K (2021). Determining appropriate levels of care for treatment of substance use disorders. Up to Date; Wolters Kluwer. Retreived from: https://www.uptodate.com/contents/determining-appropriate-levels-of-care-for-treatment-of-substance-use-disorders?search=treatment%20for%20substance%20abuse%20disorder&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

McNeely J, Adam A. Substance Use Screening and Risk Assessment in Adults [Internet]. Baltimore (MD): Johns Hopkins University; 2020 Oct. Table 3, DSM-5 Diagnostic Criteria for Diagnosing and Classifying Substance Use Disorders [abc] Available from: https://www.ncbi.nlm.nih.gov/books/NBK565474/table/nycgsubuse.tab9/

Volkow, N. D., Search for more papers by this author, Boyle, M., From the National Institute on Drug Abuse, Address correspondence to Dr. Volkow ([email protected])., M, S., Al., E., National Center for Chronic Disease Prevention and Health Promotion, AJ, W., SW, P., JJ, S., N, V., C, Y., JF, E., LJ, B., A, G., F, K., EJ, N., MB, D., … MT, S. (2018, April 25). Neuroscience of addiction: Relevance to prevention and treatment. American Journal of Psychiatry. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2018.17101174

Week 4 Discussion: Care for a Client Diagnosed with a Substance Use Disorder

1. Dashboard
2. My courses
3. NU-665C-06-23PCFA
4. Week 4: Substance Use Disorders (SUDS) and Addiction
5. Week 4 Discussion: Care for a Client Diagnosed with a Substance Use Disorder

Completion requirements

Done: Make forum posts: 1

Value: 100 points

Due: Create your initial post by Day 4 and reply to at least two of your peers by Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the following prompt.

Initial Post

For this discussion, address the following prompts:

• Elaborate on etiology, stressors, problems of addiction, dependence, and relapse in the United States today.
• Identify potential physical and mental findings when examining a client with a substance use disorder. Note your rationales.
• Describe possible triggers to compulsive substance use or behavioral addiction.
• Discuss the neurobiological mechanisms that underlie addictive behavior.
• What medication-assisted treatments (MATs) and psychotherapeutic interventions for monitoring (for alcohol and for opioid abuse) are available?

Use APA format with reference list (two to three books and/or articles).

Replies

Reply to at least two of your peers. In each of your reply posts, write a maximum of two paragraphs (with two to three sentences each). Describe what you would do differently than your peer. Also explain something new that you learned from your peers post. These paragraphs should synthesize one to two pieces of research.

Please refer to the Grading Rubric for details on how this activity will be graded.

The described expectations meet the passing level of 80%. You are directed to review the Discussion Grading Rubric for criteria which exceed expectations.  

Re: Week 4 Discussion: Care for a Client Diagnosed with a Substance Use Disorder

by Kendra Pavao – Monday, 18 September 2023, 7:35 PM

Initial Post    According to Ignaszewski, in 2017 the U.S. Department of Health and Human Services deemed the United States opioid epidemic as a public health emergency due to an increase in the number of opioid overdoses nationwide (2021). Substance abuse disorder affects a person holistically. It affects their physical and emotional health, their relationships, finances, can affect them legally, and can affect their career (Ignaszewski, 2021). The etiology of addiction can come from many different factors. Factors that can aid in causing an addiction are having a familial genetic predisposition to addiction, having a history of a mental health disorder, having a lack of support system, using addictive substances early on in life, and also can depend on what kind of addictive agent the person is using (Hatoum et al., 2022). Factors that complicate addiction even further are socioeconomic inequalities nationwide and the stigmatization that seems to be attached to addiction (Ignaszewski, 2021). Having an addiction causes many stressors for a person. These stressors include constant stress over keeping up with the supply of running out of the substance the person is addicted to, financial stress, and the feeling of being reliant on a substance (Al’Absi, 2020). Dependence occurs due to addictive substances turning on the mesolimbic/dopamine reward system in the brain that gives the person a sense of reward after activating it (Szalavitz et al., 2021). This reward feeling then becomes addicting when the person uses the substance regularly. This feeling then stops when the person stops utilizing the substance, which then causes the person to crave that reward sensation. This is when a relapse is likely to occur.

     Some physical findings identifiable when examining a client with substance use disorder are restlessness, dilated pupils, hyperactivity, or lethargy (Szalavitz et al., 2021). People using opioids will have constricted pupils due to opioids stimulating the parasympathetic nervous system (Ignaszewski, 2021). Some mental findings identifiable when examining a client with substance use disorder are euphoria, irritability, hallucinations, paranoia, and unexplained personality changes (Szalavitz et al., 2021). Aggressive outbursts are common with alcohol use disorder due to alcohol impairing judgment and impulsivity (Parrott & Eckhardt, 2018).

    Some possible triggers of compulsive substance or behavioral addiction are when seeing someone use a substance they once used, having vivid dreams or thoughts, or talking about memories about using substances in the past (Asensio et al., 2020). A common trigger clients with a history of substance use disorder share is when they see old friends that they once got high with in the past. Sometimes these clients move to a different location such as out of their city or to a different state to help the success of their sobriety.

     An example of a medication-assisted treatment (MAT) is using the medication Buprenorphine (Suboxone) to help clients with a history of opioid use disorder from not using opioids. Buprenorphine is a proven safe and effective way to help these clients from using prescription opioids (Moryl et al., 2020). Some psychotherapeutic interventions used for monitoring alcohol and opioid abuse are group therapy, cognitive behavioral therapy, alcoholics anonymous (AA) meetings for clients with a history of alcohol use disorder, and Narcotics Anonymous (NA) meetings for clients with a history of opioid use disorder (Bhide & Chakraborty, 2020). 

References

Al’Absi M. (2020). The influence of stress and early life adversity on addiction: Psychobiological mechanisms of risk and resilience. International review of neurobiology, 152, 71–100. https://doi.org/10.1016/bs.irn.2020.03.012

Asensio, S., Hernández-Rabaza, V., & Orón Semper, J. V. (2020). What Is the “Trigger” of Addiction?. Frontiers in behavioral neuroscience, 14, 54. https://doi.org/10.3389/fnbeh.2020.00054

Bhide, A., & Chakraborty, K. (2020). General Principles for Psychotherapeutic Interventions in Children and Adolescents. Indian journal of psychiatry, 62(Suppl 2), S299–S318. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_811_19

Hatoum, A. S., Johnson, E. C., Colbert, S. M. C., Polimanti, R., Zhou, H., Walters, R. K., Gelernter, J., Edenberg, H. J., Bogdan, R., & Agrawal, A. (2022). The addiction risk factor: A unitary genetic vulnerability characterizes substance use disorders and their associations with common correlates. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 47(10), 1739–1745. https://doi.org/10.1038/s41386-021-01209-w

Ignaszewski M. J. (2021). The Epidemiology of Drug Abuse. Journal of clinical pharmacology, 61 Suppl 2, S10–S17. https://doi.org/10.1002/jcph.1937

Moryl, N., Filkins, A., Griffo, Y., Malhotra, V., Jain, R. H., Frierson, E., & Inturrisi, C. (2020). Successful use of buprenorphine-naloxone medication-assisted program to treat concurrent pain and opioid addiction after cancer therapy. Journal of opioid management, 16(2), 111–118. https://doi.org/10.5055/jom.2020.0557

Nawi, A. M., Ismail, R., Ibrahim, F., Hassan, M. R., Manaf, M. R. A., Amit, N., Ibrahim, N., & Shafurdin, N. S. (2021). Risk and protective factors of drug abuse among adolescents: a systematic review. BMC public health, 21(1), 2088. https://doi.org/10.1186/s12889-021-11906-2

Parrott, D. J., & Eckhardt, C. I. (2018). Effects of Alcohol on Human Aggression. Current opinion in psychology, 19, 1–5. https://doi.org/10.1016/j.copsyc.2017.03.023

Szalavitz, M., Rigg, K. K., & Wakeman, S. E. (2021). Drug dependence is not addiction-and it matters. Annals of medicine, 53(1), 1989–1992. https://doi.org/10.1080/07853890.2021.1995623