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Overview of Tanya’s Case
Tanya was physically and sexually abused as a child. This caused her to experience depression and anxiety. As a way of coping with her situation and the symptoms she felt, she turned to drugs and alcohol. However, this only exacerbated the situation, as she began chasing ever-fleeting and harder-to-obtain highs. She ran away from home as a teenager and ended up on the streets selling her body for money or drugs and finally selling drugs herself. Years went by like a blur, as her addiction to cocaine, crack, heroin and alcohol took its toll on her body. She had no support system, continued to be abused by those in her environment and was finally arrested for possession.
Tanya went through withdrawal in prison, which made her feel worse than anything before. It was “like hell” for her (The Louis de la Parte Florida Mental Health Institute, 2002, p. 24). Tanya needed an intervention to help her right her mind and help her to obtain some control over her body once more. She also desperately needed a support system—something she had never obtained or possessed before in her life. This support system would enable her to fulfill her most basic needs, according to Maslow’s (1943) hierarchy of needs theory.
Assessment and Diagnosis
The Addiction Severity Index (ASI) is a useful tool in assessing Tanya as it allows for assessment to take place through a structured interview process that allows the care provider to obtain information on seven distinct areas: (1) medical conditions, (2) employment/support, (3) use of alcohol and drugs, (4) legal issues, (5) family history, (6) family/social relationships, and (7) psychiatric disorders (Samet, Waxman, Hatzenbuehler, & Hasin, 2007).
There are 12 steps to any assessment process (Saks & Ries, 2005):
· Assessment Step 1: Engage the Client—the rationale being to obtain information directly from the source.
· Assessment Step 2: Identify and Contact Collaterals (Family, Friends, Other Providers) To Gather Additional Information—so as to obtain information from secondary sources.
· Assessment Step 3: Screen for and Detect Co-Occurring Disorders—so as to understand the full scope of the patient’s problems.
· Assessment Step 4: Determine Quadrant and Locus of Responsibility—so...
Most affected are visuomotor performance, attention, inhibitory control, and verbal memory. Several studies have found abnormalities of behavioral regulation and risk–reward decision making. This type of impairment is associated with lesions of the frontal cortex, a brain area that shows decreased regional blood flow and metabolic activity in abstinent cocaine abusers” (p. 230). Tanya’s addiction to crack has impaired her mental and physical condition. Her use of alcohol and heroin to help her to sleep after her physical highs indicates her reliance on chemicals to function normally. The charts below explain the pharmacodynamics and pharmacokinetics of her drug and alcohol abuse:
Source: Martin & Patel (2016).
Diagnosis
According to DSM-5, Tanya may be diagnosed with polysubstance abuse, as “among opioid addicts, cocaine and alcohol are the most frequently abused substances,” which is exactly Tanya’s case (“Signs and Symptoms of Polysubstance Abuse,” 2015). The criteria for this diagnosis include strong desire to…
References
Ekinci, S., Kandemir, H. (2015). Childhood trauma in the lives of substance dependent patients: The relationship between depression, anxiety and self-esteem. Nord Journal Psychiatry, 69(4): 249-253.
Giordano, A., Prosek, E., Stamman, J. et al. (2016). Addressing Trauma in Substance Abuse Treatment. Journal of Alcohol and Drug Addiction, 60(2): 55-71.
Gorelick, D. & Baumann, M. (2016). The pharmacology of cocaine. Retrieved from https://basicmedicalkey.com/the-pharmacology-of-cocaine-amphetamines-and-other-stimulants/#head8
The Louis de la Parte Florida Mental Health Institute (2002). Co-occurring disorders treatment workbook. Retrieved from: http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=1593&context=mhlp_facpub
Martin, P. & Patel, S. (2016). Pharmacology of drugs of abuse. Retrieved from https://basicmedicalkey.com/pharmacology-of-drugs-of-abuse/
Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370.
Sacks, S., & Ries, R. K. (2005). Substance Abuse Treatment for Persons With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. Substance Abuse and Mental Health Services Administration.
Samet, S., Waxman, R., Hatzenbuehler, M., & Hasin, D. S. (2007). Assessing addiction: Concepts and instruments. Addiction Science & Clinical Practice, 4(1), 19.
Signs and Symptoms of Polysubstance Abuse. (2015). Buppractice. Retrieved from https://www.buppractice.com/node/12376
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