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Case analysis Mental Health problems and Addiction

Describe substance abuse and exactly how it is different from material dependence.

Substance mistreatment is when an individual "Overindulgences within an addictive substance" (New Oxford American Dictionary. Based on the Neurobiological Factors behind Addiction, drug abuse is a "Maladaptive structure of drug use resulting in impairment or distress presenting as one or even more of the following in a 12 month time frame (Erickson & Wilcox 2001):

Recurrent use leading to failure to satisfy major obligations

Recurrent use which is bodily hazardous

Recurrent drug-related legal problems

Continued use despite sociable or social problems

and the person has never attained the standards for product dependence" (Erickson & Wilcox 2001). A person that has a compound dependence is when a person uses a substance regardless of the negative affects that may occur, such as: withdrawal, and compulsive behavior. Regarding to Erickson, "Medicine dependence is a maladaptive style of medication use, leading to impairment or problems, delivering as three or even more of the next in a 12 month period (Erickson & Wilcox 2001):

Tolerance to the drug's actions


Drug can be used more then intended

Inability to control drug use

Effort is expended to obtain the drug

Important activities are replaced by drug use

Drug use persists in spite of negative consequences

When a person has a dependence to a substance the average person has a emotional and physical connection with the product. It really is this link between your drug and the body / brain that can have disastrous and lasting effects on the individual who gets the dependence.

5 pts

Some restoration/treatment programs stress total "abstinence" as a goal, while other advocate "harm decrease. " What exactly are the advantages/negatives of each methodology?

Abstinence is similar to from what it sounds the average person is not allowed to partake in the material they are dependent on, and these kinds of programs are effective, but the individual needs to be willing to devote themselves to this program.

Some of the advantages of abstinence range from getting the individual healthy literally and mentally. The positive aspect of abstinence is the fact the average person is no longer destroying personal property and committing crimes to fund their dependency. Therefore, abstinence retains people from the legal system including serving time for unlawful crimes and coping with the judge system for loosing custody of the children. "12 step recovery groupings such as AA and NA advocate for abstinence to provide people what they call, 'Restoration' and a big change for a much better life that is free from active craving" (Personal communication, Wright. J, 2010) Abstinence offers a support group that allows the craving to be "normalized, " and invite the given individual to link up with others who are slaves to a dependency. The average person is able to come with an since of empowerment when you are ornamented by others, who are able to keep the individual in check on their habit and personal goals.

The negatives of abstinences, "Are most troubling is the way abstinence can segregate mentally ill folks from being able to engage in treatment. This is because many people have diagnoses that want Benzodiazepines, Amphetamines and even Methadone which treatment providers consider to be highly addictive. There's a theory that a person in treatment can engage in services if they're high on prescriptions" (Personal communication Wright. J. 2010) The primary program for abstinence is AA or NA and they are based on spirituality, this may be a conflict for some of the those who are in treatment, because there religious beliefs may contradict that of the programs. It is also important to keep in mind that the average person has to want to improve their life because of this program to work. AA and NA also notify the individual that they have no electric power over their cravings, it does not allow the person to have a sense and since of empowerment. It appears to take the energy away for the individual and puts all the concentrate on the craving. Also AA and NA preaches the theory you need to go to the meetings every day and that you'll continually be an addict and that you can never be minus the dependency and that you can't ever overcome the craving. Also they have to be willing to alter their lives and commit themselves to this program: completely.

Harm reduction is an excellent alturnative to abstinence for people who cannot stop their use because they're psychologically dependance to the substance. Harm reductions can include such ideas and concepts like, using the material less, using the medication every Wed or even changing out their needles for clean ones. Some of the following are benefits and drawbacks according to the 2007 Journal of Medication Issues in English and American Medicine Clients (K. Phillips, h. Rosenburg & A. Sanikop).

Harm Decrease Advantages and Disadvantages





Reduces/eliminates/stabilizes illicit drug use facilities detoxification/relives withdrawal

More addictive and worse withdrawal then heroin, Substituting one addiction for another.

Substitute Amphetamines

Known strength, Content. Decrease need for street drugs. Offense reduction

Could encourage to utilize more at the top and OD Diversion to black markets.

Needle Exchange

Disease Prevention, Gets rid of temptation to share or reuse (needles)

Disease Prevention

Lower rates of Assists and STI

Community injury/inappropriate disposal, Makes it better to inject.

Encourages use

Drop in Centers

Safer environment NOS, OD prevention/ Prevents damage treatment facilitation

Encourages medicine use/Risk compensation.

Place where drugs can be sold.


Eases pain of withdrawal non-opiate alternative

Encourages detox/eases withdrawal

Doesn't help enough with the drawback symptoms

Drug has specific part effects


Temptation resistance

Relapse avoidance because use is waste of money

Relapse Prevention/ helps consumer quit, blocks the effects of Heroin

Can be utilized as a weapon, Clients wont take it

In the areas, Harm Reduction therapy has a stigma mounted on it that some medical practices and experts have attached to it, detouring people with drug abuse issues to use Harm Reduction. This type of therapy also does not help with co-occurring dependancies that the individual may have. It tends to concentrate on the chemical substance that the average person is addicted to and not the reason for the dependancy. It generally does not allow for the individual to isolate and get to the "root" of the issue, however, it does spend less in the medical and jail systems. The needle exchange, was started after the out period of time of HIV and Helps and the number of individuals who were diagnosed with HIV and Assists has gone down since the needle exchange was affected. As well as the number of people who are in prison for substance abuse has truly gone down because there are treatment programs including methadone that will help the individual come off their addiction to the opiate.

5 pts

Alcoholism has been described as a "bio-psycho-social" disorder. If you were performing an assessment of the defendant what factors might you look for in the client history?

Bio-psycho-social is divided into the following:

Biological Craving: is addiction that goes in the households and there maybe genetic involved in the procedure for addictions, but some of the individuals have a natural predisposition to addiction

Psychological Obsession: That dependency is a discovered behavior. This can include, domestic assault and learning how to employ a drug. One becomes obsessed by the PLEASURE that the substance can offer.

Social Aspect: Surroundings that individuals grow up in which environment may strengthen addictive manners.

It is these concepts that create the bio-psycho-social theory, it is an proven fact that is steeped in the theory of person in environment. It requires in accounts the individuals biology, mental health health and communal wellbeing and support to totally understand the "root" of the folks addiction. According to the Handbook of Forensic Mental Health ( D. Springer & A. Roberts 2007 p. 350-352) listed below are questions and information you need to gather in order to be able to totally complete an diagnosis:

"Presenting Problems: Record current problems as reported by the children, family, referral source and any essential others, Are the record and development of the challenge, circumstances surrounding the challenge and the previous attempts to solve the condition. Development (birth to current era): explain prenatal care, delivery, accomplishments of developmental milestones, delays and delivery defects.

Family Qualifications: explain the family constellation, family working and communication. Include socioeconomic, educational and occupational information. Describe family childrearing and parenting tactics.

Academic Background: Describe previous diagnoses and the annals of mental problems and services. Include medication record and any background of self-injurious manners and or suicide tries.

Psychological Background: Describe previous diagnoses and the annals of mental health problems and services include medication background and any record of self-injurious habits and or suicide efforts.

Substance Abuse Background: Describe the youth's use and abuse of all substances; include the period, method, and location useful and the young families history of product use.

Juvenile Justice or Legal Record: Describe previous encounters with the juvenile justice system and the history of illegal manners and status offense. include timeline, type, and circumstances of offense as well as the family history of legal problems.

Violence and Abuse Background: Detail subconscious, verbal, physical, and intimate maltreatment of the children you need to include a timeline. Identify perpetrators and illustrate whether the abuse took place in or outside of the family. Describe any family or going out with violence that the young ones perpetrated. include any other traumas that the young ones was subjected to.

Medical Record: Describe the history of medical conditions diseases and medication of junior Include the genealogy.

Cultural Record: Identify the ethnicity and rase of the youth and family include any issues known regarding bicultural individuality, immigration status, terms obstacles, acculturation and discrimination.

Lethality: Evidently identify any concerns with lethality of the youngsters either towards him or herself or others and express the program for handling this lethality. "

Bio-psycho-social is a holistic approach when dealing with somebody's addictive behavior. It really is based on a continuum procedure, that is backed by a since of empowerment. It allows the individual to understand why they many have started to be addicted to a element that is plaguing them, and provides them the tools that is needed to understand their habit and preventing themselves from relapsing.

5 pts

Historically, lots of theories or types of alcoholism have improved. What exactly are these models and what is their relevance for today?

These models provide a guideline and help create a knowledge in why people become addicted to specific substances. These models range from natural reasoning to environmental, nevertheless they are all connected in trying to find why people become addicted to substances: each of them strive to make a public knowledge of addiction. They do not make an effort to make excuses for those who are addicted, nevertheless they try to understand why craving occurs.

Theoretical Models of Liquor/Drug Abuse

From the Ideas of Chemical substance Dependency by: H. Doweiko

Moral Model

Temperance Model

Spiritual Model

Dispositional Disease Model

Core Element

The individual can be regarded as choosing to use alcohol in problematic manner

This model advocates the use of liquor in average manner

Drunkenness is a vision that the average person has slipped from his / her intended avenue in life.

The one who becomes dependent on alcohol is somehow not the same as the nonalcoholic. The alcoholic might be said to sensitive to alcohol

Educational Model

Characterological Model

General Systems Model

Medical Model

Core Element

Alcohol problems are the effect of a lack of enough knowledge about hazardous ramifications of this chemical

Problems with liquor use are based on abnormalities in the personality framework of the individual

Personal patterns must be looked at within context of interpersonal system where they live

The individual use of alcohol is dependant on natural predispositions such as his / her genetic heritage brain physiology and so forth.

(Harold Doweiko. 2009. pp. 30)

The models which have the most relevance for today needs to be the medical model and the overall systems model. Because by looking at the person in a all natural way we can understand that the individual is affect by habit in three ways: biologically, psychologically, and socially and those two ideas envelop those ideals. I think that when you realize the individuals natural and social characteristics, you will understand there obsession.

5 pts

In talking about the neurobiology of addiction, the word neuroplasticity is used to describe what brain process?

Neuroplasticity is when the mind is altered anticipated to chemicals, and it is forced to change to be able to adapt to the chemical. Once the chemical has been removed from the individual drawback starts to occur, because the mind has a hard time functioning with no substance it's been forced to adapt to. Because the brain is good at making adjustments the body is capable of adapting to the dangerous chemical, and the body learns how to function with the additive. With no chemical your body has to modify itself to relearn how to function without the chemical.

5 pts

Dr. Eugene Prochaska has developed a treatment approach based on "Levels of Change. " What is the thinking behind this model and exactly how it is utilized in treating substance abusers?

The purpose of this model is to understand the way the cognitive and behavioral methods affect the individual who is dependent on chemicals. Corresponding to Porchaska the, "Purpose (of) the transtheoretical model (TTM) of health behavior looks for to bridge the cognitive and the behaviorist techniques by positing some stages in modifying behavior; in mere some of these are cognitive processes essential" and "The model includes four main constructs: the sequential levels of change; procedures which people typically use to aid change; decisional balance, which predicts whether change will take place; and self applied- efficacy, the person's self-assurance they can make changes" (Prochaska. 1985. pp. 1).

Stages of Change

Stages of Change and the Transtheoretical Model By: E. Prochaska




The person does not have any intention in changing the tendencies, usually within the next six months. This maybe credited to lack of information or confidence. The individual is unmotivated and will resist talking about or considering making the change. They aren't ready for interventions.


The person expresses and objective to do this within half a year. They know about the benefits and cost of earning the change which balance may keep them in the phase for a long time. They are not ready for an treatment that needs immediate action.


The person intends to take action in the immediate future. They typically have an idea of action and they have taken some preparatory action. They are prepared for traditional action interventions


The person has specific changes to their lifestyle


The person works to avoid relapse; during this phase their confidence rises as they continue with their new lifestyle.


In rule the maintenance stage will lead to a period where the person is no longer tempted to revert to their former patterns and the change is complete.

This model suggest that in order to overcome an craving you have to go though a linear model. I do not think that the individual with the substance abuse has to go though all these steps in order to "kick the habit. " I also believe this model places all the blame on the individual because it will not take into account the individual biology and or the surroundings that the individual is surrounded by. The thinking behind this model is that these are the levels that an person that has a substance abuse dependency must go though to be remembered as "clean" and if they are in a position to follow this model they will finally have the ability to "kick the habit. "

5 pts

How is crystal meth different from other stimulants such as cocaine? What exactly are some of the long-term effects associated with meth use?

According to the Powerpoint provided by the Section of Health and Human Services (SHMHSA) the differences between methamphetamine and cocaine are:

Cocaine results: one to two 2 time.

Methamphetamine results: 8 to 12 hours.

More intense "hurry" or initial pleasure (I'd add. )

Withdrawal from methamphetamine can cause more powerful symptoms and last longer.

The Long-term psychological effects of using meth are:


Reduction of capacity to concentrate and set up information

Damage of capacity to feel pleasure with no drug


Insomnia and fatigue

Disposition swings

Irritability and anger


Stress and anxiety disorder

Reckless, unprotected erotic behavior

The more sever emotional effects can include:


Severe unhappiness that can result in suicidal thoughts or attempts

Episodes of unexpected, violent behavior

Severe memory reduction which may be permanent

The chronic physical effects are:



Dry mouth

Weight damage/malnutrition

Increased sweating

Oily skin



Severe issues with tooth and gums Sever Physical:


Damaged blood vessels in the brain/stroke

Damaged brain cells

Irregular heartbeat/rapid death

Heart assault or chronic heart and soul problems

Kidney failure

Liver failure


Infected pores and skin sores

5 pts


Department of Health and Individuals Services. SHMHSA. (12 months unknown) Procedure 4: methamphetamine and cocaine, TCRIM 361 Summer season 2010. University of Washington Tacoma.

Doweiko, H. (2009). Principles of substance dependency: psychological types of chemical use disorders. Brooks/cole cengage learning. Belmont CA. ISB: 13-978-049550580-8

Erickson, Carlton K. and Wilcox, Richard E. (2001) 'Neurobiological factors behind habit', journal of interpersonal work practice in the addictions, 1: 3, 7 - 22

DOI: 10. 1300/J160v01n03_02 Web address: http://dx. doi. org/10. 1300/


Phillips, K. , Rosenberg, H. , & Sanikop, A. (2007). British and american medicine clients' view of the acceptably, advantages and disadvantages of treatment and damage lowering interventions. Journal of Medication issues, 37(2), 377-402. Retrieved from Academic Search Complete repository.

Prochaska, J. (1985). Periods of change and the transtheoretical model.

Springer W. , Roberts A. , (2007) Handbook of forensic mental health with victims and offenders: examination, treatment, and research. Springer Series on Community Work. New York. ISBN: 0826115144

Wright. J. (2010, Aug. 8). Personal communication. University of Washington.

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