Substance Abuse Treatment Analysis of David Ruffin Most people today probably recognize his signing voice from his hits such as "My Girl," but few may remember David Ruffin of The Temptations music group from the latter half of the 20th century. Like many of his contemporaries, Ruffin fell victim to the ravages of drug abuse during the height of his career, leaving his millions of fans with a musical void in their lives. To gain some further insights into his untimely death from an overdose of cocaine, this paper provides a review of the relevant peer-reviewed and scholarly literature to develop a background and an overview of Ruffin, his use of drugs, and an appropriate screening instrument that could be used to evaluate a similar client's stage of dependence, change or recovery. An application of this diagnostic tool to Ruffin's unique circumstances is followed by a discussion concerning possible placement options and treatment modalities for clients with Ruffin's diagnosis, and the rationale in support of their choice based upon a personal conceptualization and etiology of addiction. Finally, a summary of the research and important findings are presented in the conclusion.

Review and Discussion

Background and Overview of David Ruffin

The hit soul group, "The Temptations," consisted of members Mel Franklin, Otis Williams, Eddie Kendricks, Paul Williams, Dennis Edwards and David Ruffin who began their professional recording careers with Motown Corporation in Detroit in 1962 (Claghorn, 1993). Born in January 1941 in Whynot, Mississippi, one of his biographers reports that "David Ruffin was one of the most recognizable vocalists to have emerged from the Motown Records stable. He was the younger brother of Jimmy Ruffin and the cousin of Melvin Franklin of The Temptations" (Walker, 2012, para. 2). The son of a minister, Ruffin began his musical career singing with a gospel group, the "Dixie Nightingales"; in addition, he also performed with other groups before joining up with "The Temptations" as well as recording as a solo artist in 1960 (Walker, 2012). His connections with the group and his established track record of success thus far led to his joining "The Temptations" in January 1964 as the tenor vocalist (Walker, 2012) and later as lead singer (Friedlander, 1996).

As a result, like many of his contemporaries such as Little Richard, Dinah Washington, B.B. King, Sam Cooke, Johnnie Taylor, Lou Rawls, Wilson Pickett, Billy Preston, Cissy Houston, and Delia Reese, Ruffin's music was also strongly influenced by the gospel music he heard during his youth and which he performed during his early career (Pratt, 1990). In this regard, Werner, "The deepest connection between Motown and gospel, however, sounded in the voices of the singers, all of whom grew up in and around church. You can hear it in the way David Ruffin stretches the notes on the bridges and during the fadeouts of his songs" (p. 467).( This gospel-inspired style would characterize Ruffin's musical career, and it garnered him money, countless accolades and awards -- but it also earned him respect for the breadth and scope of his work. As Werner concludes, "The technical term is melisma, but for black listeners (and the small number of whites attuned to the style) it echoed the testifying that signified the presence of the Holy Spirit. Listen carefully to the vocals on 'My Girl' and it's clear that David Ruffin understood that the pretty melody wasn't the point" (p. 468). Sam Cooke, though, appears to have been an especially influential force in Ruffin's life, helping him make the successful transition from gospel into his own distinguishable music and lifestyle (Cusic, 1990).

As noted above, in January 1964, Ruffin had joined the "The Temptations" who became star recording Motown artists. In this regard, Kinnon (2003) reports that "The Temptations personified cool in the 1960s and were one of the leaders, along with the original Supremes, of that distinctive "Motown sound" that galvanized America in the 1960s" (p. 88). Cooke's influence on Ruffin and "The Temptations" became more pronounced by this time and the transition from gospel was complete. According to Kinnon, "With their tempting 'Temptation Walk' step, their top hats and tails, the original Temptations were the original American idols. Eddie Kendricks, Paul Williams, Melvin Franklin, Otis Williams and David Ruffin had a string of hits, including The Way You Do The Things You Do, My Girl, Since I Lost My Baby, Ain't Too Proud to Beg and I Wish It Would Rain" (2003, p. 88). During his lifetime, Ruffin experienced his fair share of relationships, and was married twice, had two daughters and a son by a girlfriend (Ribowsky, 2010). Despite his troubled personal life, Ruffin's legacy in popular American culture is assured. In fact, recently, the Center for Black Music Research of Columbia College, Chicago,...

Although accounts of his death vary, one biographer cites the "peculiar madness that fame can install" and describes "The Temptations' David Ruffin stumbling into a hospital clutching a briefcase stuffed with $40,000 in cash and cheques" just prior to his death from a cocaine overdose (Ellen, 2006, p. 57). Another biographer simply states that, "A few weeks after his last performance, David Ruffin died in tragic circumstances following an overdose of crack cocaine" on June 1, 1991 at age 50 years (Walker, 2012, para. 3).
Clinical Evaluation of Ruffin

Choice of Screening Instrument. A wide range of clinical screening instruments are available with well established validity and reliability for use in evaluating clients for alcohol and other drug (AOD) abuse, including those described in Table 1 below.

Table 1

Clinical Screening Instruments for Substance Abuse and Addictions

Screening Instrument

Source/Author(s)

Addiction Severity Index

McLellan, A.T., Luborsky, L., Woody, G.E., and O'Brien, C.P. An improved diagnostic evaluation instrument for substance abuse patients: the Addiction Severity Index. Journal of Nervous and Mental Disease 186:26-33, 1980.

AUDIT

Babor, T.F., De La Fuente, J.R., and Saunders, J. AUDIT: Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care. Geneva: World Health Organization, 1989.

CAGE

Mayfield, D., McLeod, G., and Hall, P. The CAGE questionnaire: validation of a new alcoholism screening instrument. American Journal of Psychiatry 131:1121-1123, 1974.

DAST

Skinner, H.A. Drug Abuse Screening Test. Addictive Behavior 7:363-371, 1982.

DSM-III-R

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised. Washington, D.C.: American Psychiatric Association, 1987.

History of Trauma Scale

Skinner, H.A., Holt, S., Schuller, R., Roy, J., and Israel, Y. Identification of alcohol abuse using laboratory tests and a history of trauma. Annals of Internal Medicine 101:847-851, 1984.

MAST

Selzer, M.L. The Michigan Alcohol Screening test: the quest for a new diagnostic instrument. American Journal of Psychiatry 127:1653-1658, 1971.

POSIT

Rahdert, E.R. The Adolescent Assessment and Referral System Manual. DHHS pub. no. (ADM) 91-1735. Rockville, Md.: National Institute on Drug Abuse, 1991.

RHSS

Fleming, M.F., and Barry, K.L.: A three-sample test of a masked alcohol screening questionnaire. Alcohol 26:81-91, 1991.

Although all of the instruments described in Table 1 above can be useful in initiating the process of assessment by identifying clients' possible problems and determining whether they need a comprehensive assessment, some are better suited for certain situations than others, and some should only be employed by clinicians who are trained in their use. Therefore, the Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse from the Treatment Improvement Protocol (TIP) Series, No. 11 developed by the Center for Substance Abuse Treatment was selected for the evaluation of David Ruffin. The rationale for this choice was based on the guidance from the Center for Substance Abuse Treatment that states, "Ideally, a screening instrument for AOD abuse should have a high degree of sensitivity: it should be broad in its detection of individuals who have a potential AOD abuse problem, regardless of the specific drug or drugs being abused" (Chapter 2, 1994, p. 3). The AOD abuse screening instrument described below was designed to include a wide range of signs and symptoms that are indicative of substance use disorders, making it particularly useful for a broad range of applications..

The AOD abuse screening instrument identifies five primary content domains as set forth in Table 2 below.

Table 2

Five Primary Content Domains of the AOD Abuse Screening Instrument

Content Domain

Description

AOD Consumption

A person's consumption pattern - the frequency, length, and amount of use - of AODs is an important marker for evaluating whether he or she has an AOD abuse problem. Patterns of AOD consumption can vary widely among individuals or even for the same individual. Although substance use disorders often consist of frequent, long-term use of AOD, addiction problems may also be characterized by periodic binges over shorter periods.

Preoccupation and Loss of Control

The symptoms of preoccupation and loss of control are common in persons with substance use disorders. 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.…