Assessment and Treatment Recommendations Worksheet

Substance Use History:

PSYC FPX4300 Assessment 3 I’ve Got You Pegged (Treatment Plan)

Follow-On Question: Have These Drugs Ever Been Used in Combination?

No, my client started with one pill of Xanax daily to cope with the anxiety of his mother getting a divorce, as he pretended by him. However, he did not show any kind of physical effects and was unaware of the consequences of the medication. But he did not use the drugs in combination with any other material. If he had done so, the factors would have been obvious, which involves the slowing down of heart rate, drowsiness, and leading to slow breathing. None of the stated consequences have been experienced by him yet. Thus, it is safe to say that he did not use Xanax in combination with alcohol or any other opioid drug. But Michael has been using quite a high dose of Xanax and has also been supplying it to his friends. The dosage foremost should not be taken as Michael does not need the medication and is utilizing it for recreational purposes only. Moreover, the dosage should be monitored in order to have a check and balance upon its use. 

Physical Consequences

Michael doesn’t have any physical-looking effect. He said that he was ignorant of the physical consequences of Xanax. He said that he’s consuming daily 4 to 5 tablets. But he’s unaware of his physical consequences and also has not shown any effect. 

Psychological Consequences

According to the case study, Michael’s parents are always fighting, and it’s very prickly for Michael. It also shows that Michael doesn’t indeed care about them. His parents are always used to fighting, and they’re unaware of Michael’s substance use habit. He was very disturbed due to his parents, and it shows he does not feel cautious about that if his parents find out about his substance use. His parents are super religious, but Michael also doesn’t like this because he’s gay.

Medical Concerns

Michael is taking Xanax four to five times daily, and it can cause swear problems and some of them related to Michael, like headache, aggression, blurred vision, and insomnia. Case of a youthful grown-up who came unresponsive after insufflating what he believed to be crushed Xanax. Naloxone was administered, reversing his altered internal status and respiratory depression. Clinicians suspected opioid toxin; still, the case adamantly denied opioid use. (Chapman et al., 2019). The abuse of the drug can cause serious consequences, which are stated as follows.

• The drug can induce lightheadedness, dizziness, reduced alertness, and inability to focus on any of the tasks, which could lead to dangerous consequences. 
• The intake of the drug affects the liver straight away by inducing abdominal pain, nausea, and vomiting. This results in an increased level of enzymes in the liver, which can ultimately lead to jaundice causing further degradation of the health of the liver. 
• The induction of high impulse in the body can result in shaking and jerking movements of the body, and the individual can be jerking and flopping throughout. However, Michael is unaware of the physical consequences of the drug and has not been experiencing them yet. But increased intake can lead to the development of seizures in the individual. 
• Ultimately, the intake of the drug can cause serious and permanent consequences on the brain of the person, which can result in the occurrence of hallucinations. The person can be involved in such false alarms and have a permanent to the brain (DeRight, 2021). 

Past Treatment History

In Michael’s past medical records, Michael doesn’t have any substance use history. He consulted the doctor after the family was stressed and the doctor prescribed him Xanax. Thus, his past present or use of a substance or any other addiction. But the current perspective states his addiction to Xanax. He has been overdosing on the drug, causing his inclination toward the serious side effects of the medication. His psychology plays a major role in the perspective as he is gay and wants his parents to accept that. However, the parents have been involved in their own conflicts and are unable to have time for him. Resultantly, he has been abusing Xanax, which might lead to serious consequences. 

Environmental Factors

Residential

Michael’s parents are already separated due to divorce. Michael is currently with his mother, and his dad visits every other weekend. However, tension might be present, but the condition of living is rather bearable. Both of his parents are involved in drinking, but none of them has been falling on the bad side of it. However, the common substance abuse case can be considered from this perspective. His brother has been involved in the utilization of weed. As like begets like, he has been involved in the substance abuse of Xanax. Thus, he followed the example of his brother. Another downside involves that as he knows his brother had been caught in the act, he stays extra careful in the consumption of Xanax so that his school and his parents are unable to figure it out. 

Social Support System

Michael’s friends are also addicted to Xanax and they share it. They are not about to support Michael. Moreover, it can be stated how his friend has been inducing the excessive use of Xanax. He has been lying to his doctor so that he is able to extract more and more of the drug to be shared with his friends. On the other hand, the parents didn’t know about the situation of Michael. He was addicted. They are also not supportive. The core of the problem lies in the aspect as if their parents have accepted their condition and their sexuality more, and they might not have fallen prey to the addiction. His brother has also been involved in the use of weed which may depict a problem with parenting resulting in the implication of stating how Michael has been a part of the problem through parenting. 

PSYC FPX4300 Assessment 3 I’ve Got You Pegged (Treatment Plan)

Family and Family History

Family History Of Use

As Michael said, his parents drink but not extremely. His elder brother was also suspended from school due to the use of weed. His parents have no drug history except for his elder brother. The case seems to be more typical of a white boy trying to gain attention from his parent amid their own family crisis, which has resulted in his downfall towards the addiction. 

Family Mental Health History

Michael’s mother has been seeing a therapist after her divorce, and she is also suffering from depression. There are not any other mental issues in the family. Even the current state of her mother is the result of the environmental factor inducing stress on her else there is no family history present to affect Michael. 

Current Additional Status to Consider

Educational Status

Michael is currently in middle school, and he’s 14 years old. He’s expecting to join high school next year. By the nature of his involvement with the school and his friend, it does not depict that he has stressed about his education.

Financial Status

Michael has not told me about financial issues, and he’s too young to work himself.

Legal Status

Michael is not subject to any legal issues currently and in the past. 

Motivation for Treatment

Michael’s problem is related to substance use, and he’s not ready to quit it. He’s not presently apprehensive of his issues, and he’s not presently getting remedies for them. He most likely sees a doctor due to his parent’s separation. Michael thinks he has a problem, but he does not know he has a medicine abuse problem. He’s also not prepared for his treatment. He thinks that it’s okay to get Xanax capsules because he’s satisfied with them.

Recommended Assessment Measures

I recommend the abuse screening in which they check the level of substance use. Also, learning about Michael’s thinking and how things get helpful for him to determine the actual cause of his substance use. In the treatment of substance use complaints, regular laboratory-grounded testing has the binary purpose of covering compliance with the specified drug and abstention from medically on-motivated substances (i.e., medicine abuse screening). The top instance for testing is urine, but a collection of urine has some disadvantages. This design exhaled breath and oral fluid as indispensable matrices for medicine abuse webbing in cases of substance use (Arvidsson et al., 2018).

We can use the NIDA help to assess the use of marijuana, heroin, cocaine, or capsules not specified by a croaker, similar to Xanax, Valium, and oxycodone. We examined each medicine collectively and created a count variable to examine polysubstance use. We assessed post-traumatic stress complaint symptoms (PTSD) using the Primary Care- PTSD, general anxiety complaint(GAD) symptoms using the GAD- 7, and major depressive symptoms(MDD) using the Patient Health Questionnaire (PHQ- 9) (Lesko et al., 2021).

Reduced Clostridia was constantly seen in those with depression, independent of the presence of anxiety. Again, reduced Bactericides may be more associated with the presence of anxiety, independent of the presence of depression (Czysz et al., 2021).

Clinical Assessment 

Recent variations of the Diagnostic and Statistical Manual of Mental Disorders (DSM) increasingly admit the significance of the artistic environment for the opinion of internal illness. Still, these same variations include evolving individual criteria that contemporaneously decontextualize particular diseases similar to Major Depressive Disorder (MDD) and Post-traumatic Stress Disorder(PTSD) (Langa & Gone, 2019).

In the treatment of people with possible substance use diseases, Findings suggest that the use of PDMP. Stressed pressures between providers’ smirch toward substance use diseases and the clinical care of people who use medicines, challenging their conceptions and impulses (Allen et al., 2019). This model of DSM-5 and ICD-10 brings together individual, cerebral and experimental approaches to match specific behaviors to identifiable neural mechanisms (Holland et al., 2019).

Treatment Recommendations

It’s important that Michael get to know his condition. He needs support to come out of that. Medicine consumption is driven by a medicine’s pharmacological goods, which are endured as satisfying, and is told by inheritable, experimental, and psychosocial factors that intervene in medicine availability, morals, and social support system (Volkow et al., 2019). It is clear that Michael actually needs love from his parents. He will agree to get treatment when they motivate and show love to Michael. His parents need some more effort to overcome Xanax addiction. Many therapies have been introduced to deal with problems, and detoxification is one of them. This study aimed to probe the relationship between cerebral adaptability and medicine dependence and examine the underpinning mediational places of maladjustment and freakishness in this association. Studies have shown that cerebral adaptability is a crucial factor in medical recuperation. (Zhuo et al., 2011)

PSYC FPX4300 Assessment 3 I’ve Got You Pegged (Treatment Plan)

Ethical Consideration

In health care, ethical issues can be epistemic, affiliated with deceived, inconclusive or inscrutable substantiation; normative, affiliated to illegal issues and transformative effective; or related to traceability (Morley et al., 2020). It’s important that Michael’s information should not be shared with anyone, including friends and family. This case can be disclosed to his parents because Michael is too young to handle it. From an ethical standpoint, improvements in internal medicine include novel treatment modalities, improved patient response, and more time for doctors (Fiske et al., 2019).

Conclusion

It concludes that Michael is a 14-year-old kid who’s addicted and suffering from substance use issues. He daily takes 4 to 5 tablets of Xanax and feels relaxed after them. Michael’s parents are divorced, and he lives with his mother. His parents are not taking good care of him. He needs detoxification and therapy to get rid of this substance use problem.

References

DeRight, J. (2021). Cognitive side effects of common medications. Essential Neuropsychology: A Concise Handbook for Adult Practitioners, 17–25. https://doi.org/10.1007/978-3-030-85372-3_4

Fiske, A., Henningsen, P., & Buyx, A. (2019). Your robot therapist will see you now: ethical implications of embodied artificial intelligence in psychiatry, psychology, and psychotherapy. Journal of Medical Internet Research, 21(5), e13216. https://doi.org/10.2196/13216 

Morley, J., Machado, C. C. V., Burr, C., Cowls, J., Joshi, I., Taddeo, M., & Floridi, L. (2020). the ethics of ai in health care: a mapping review. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3830408 

Allen, B., Harocopos, A., & Chernick, R. (2019). Substance uses stigma, primary care, and the new york state prescription drug monitoring program. Behavioral Medicine, 46(1), 52–62. https://doi.org/10.1080/08964289.2018.1555129 

Arvidsson, M., Ullah, S., Franck, J., Dahl, M.-L., & Beck, O. (2018). Drug abuse screening with exhaled breath and oral fluid in adults with substance use disorder. Drug Testing and Analysis, 11(1), 27–32. https://doi.org/10.1002/dta.2384 

Chapman, B. P., Lai, J. T., Krotulski, A. J., Fogarty, M. F., Griswold, M. K., Logan, B. K., & Babu, K. M. (2019). A case of unintentional opioid (u-47700) overdose in a young adult after counterfeit xanax Use. Pediatric Emergency Care, Publish Ahead of Print. https://doi.org/10.1097/pec.0000000000001775 

Czysz, A. H., Mason, B. L., Li, Q., Chin-Fatt, C., Minhajuddin, A., Carmody, T., & Trivedi, M. H. (2021). Comparison of inflammatory markers as moderators of depression outcomes: A CO-MED study. Journal of Affective Disorders, 295, 1066–1071. https://doi.org/10.1016/j.jad.2021.08.116 

Holland, A. J., Aman, L. C. S., & Whittington, J. E. (2019). Defining mental and behavioral disorders in genetically determined neurodevelopmental syndromes with particular reference to the prader-willi syndrome. Genes, 10(12), 1025. https://doi.org/10.3390/genes10121025 

Langa, M. E., & Gone, J. P. (2019). Cultural Context inDSMDiagnosis: An American Indian case illustration of contradictory trends. Transcultural Psychiatry, 136346151983247. https://doi.org/10.1177/1363461519832473 

Lesko, C. R., Hutton, H. E., Fojo, A. T., Shen, N. M., Moore, R. D., & Chander, G. (2021). Depression and HIV viral non suppression among people engaged in HIV care in an urban clinic, 2014–2019. AIDS, 35(12), 2017–2024. https://doi.org/10.1097/qad.0000000000003005 

Liese, B. S., Kim, H. S., & Hodgins, D. C. (2020). Insecure Attachment and Addiction: Testing the Mediating Role of emotion dysregulation in four potentially addictive behaviors. Addictive Behaviors, 107, 106432. https://doi.org/10.1016/j.addbeh.2020.106432 

Sartori, S. B., & Singewald, N. (2019). Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacology & Therapeutics, 204, 107402. https://doi.org/10.1016/j.pharmthera.2019.107402 

Volkow, N. D., Michaelides, M., & Baler, R. (2019). The neuroscience of drug reward and addiction. Physiological Reviews, 99(4), 2115–2140. https://doi.org/10.1152/physrev.00014.2018 

Zhuo, Y., Tang, S., Jiang, Y., Zhang, C., Reddish, F., & Yang, J. J. (2011). Application of designed calcium sensors with fast kinetic responses. Biophysical Journal, 100(3), 554a. https://doi.org/10.1016/j.bpj.2010.12.3223 

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