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4 pages/β‰ˆ1100 words
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APA
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Health, Medicine, Nursing
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English (U.S.)
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Topic:

Diagnostic Information and Measures for Substance Dependent Patient

Essay Instructions:

Richard is a 62-year-old single man who says that his substance dependence and his bipolar disorder both emerged in his late teens. He says that he started to drink to “feel better” when his episodes of depression made it hard for him to interact with his peers. He also states that alcohol and cocaine are a natural part of his manic episodes. He also notes that coming off the cocaine and binge drinking contribute to low mood, but he has not responded well to referrals to AA and past inpatient stays have led to only temporary abstinence. Yet, Richard is now trying to forge a closer relationship with his adult children, and he says he is especially motivated to get a better handle on both his bipolar disorder and his substance use. He has been more compliant with his mood-stabilizing and antidepressant medication, and his psychiatric provider would like his dual diagnoses addressed with psychotherapy.
1. What diagnostic information would be most critical to collect in the first visit?
2. Which diagnostic measures are recommended by the US clinical guidelines for the treatment of this patient’s family problem?
3. Which evidence based harm reduction strategies would you recommend to treat this patient?
4. Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient(Miami). (These agencies must not have been used in past discussion posts){used agencies CIFC Counselling located at 1401 SW 1st Street, Suite 100 in Miami, Florida. CIFC is the CMCH located at 1951 NW 17th Avenue Miami, FL. MiMo Psychotherapy Group is located in MiMo District on the Upper East Side}. What was your rationale for choosing these three agencies?

Essay Sample Content Preview:

Substance Dependence Case Study
Author’s Name
The Institutional Affiliation
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Assignment Due Date
Substance Dependence Case Study
Introduction
This assignment aims to discuss a case study of Richard, a 62-year-old single man with bipolar disorder and substance dependence from his late teens. Richard has a history of using cocaine and alcohol to lower his mood. The assignment discusses the diagnostic information and measures regarding substance abuse and presents evidence-based harm reduction strategies which should be recommended to treat the patient.
Diagnostic Information to be collected for Richard
Richard meets the diagnostic criteria for mixed substance abuse or dependence. Although he had been in remission, he is experiencing potential cravings for alcohol and cocaine due to certain behavioral prompts. Possible symptoms include mania, impulsivity, depression, elevated mood, and alcohol use. The use pattern depends on gender, age, and social status (Bentzley et al., 2021). Under conditions of an already formed dependence on one drug, dependence on other drugs is formed rather quickly.
The defining feature of the disease in such cases is the formed mental dependence, i.e., a pathological attraction to another drug, expressed as clearly as to the predecessor. Forming a stable long-term remission is difficult and unlikely in the disease's dynamics.
The health professional must collect data about Richard’s family and cultural background, his occupational history, behavioral characteristics, and information related to Richard’s drug use and sexual and social histories.
Diagnostic Measures for Richard
The combined use of alcohol and opioids is common in clinical practice (Bentzley et al., 2021). Often, the first trials of opioids occur intending to alleviate the withdrawal syndrome. Another common option is the use of the drug in remission. Against the background of the actualization of a pathological craving, for example, for opioids, the patient tries to satisfy this craving by taking another socially acceptable alternative, alcohol.
According to the US clinical guidelines for treating this patient’s family problem, the screening and diagnosis must be prioritized (CPNP, 2021). Considering the combined use of alcohol and cocaine and other psychostimulants, research indicates that patients suffering from addiction to cocaine or other psychostimulants often switch to alcohol during the disease. As a rule, this is due to attempts to "soften" the withdrawal syndrome of cocaine and other psychostimulants (Ray et al., 2020). The combined use of cocaine and alcohol is more typical for Europe and the USA: the diagnosis of alcohol dependence can be established in 50 to 90% of cocaine addicts
For diagnostic purposes, the following biomarkers of alcohol abuse are currently used:
1 AST ratio /AlAT and MCV
2 Carbohydrate-deficient transferrin
3 Mean erythrocyte volume (MCV)
4 Gamma-glutamyltransferase (gamma-GT)
5 Alanine aminotransferase (ALT)
6 Aspartate aminotransferase (AST)
Evidence-Based Harm Reduction Strategies
Harm reduction consists of specific policies and strategies designed to reduce the negative eff...
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