Feb 23, 2024 HCA 250 Week 6 Assignment Substance Abuse Paper
HCA 250 Week 6 Assignment Substance Abuse Paper
HCA 250 Week 6 Assignment Substance Abuse Paper
Choose one of the following topics:
• Smoking tobacco
• Alcohol abuse
• Drug abuse
Write a 500- to 750-word paper that addresses this problem.
Address the following in your paper:
• Discuss psychological factors that influence whether individuals start to smoke, drink alcohol, or use drugs.
• Describe the effects of tobacco, alcohol, or drug abuse in the workplace.
• Explain how employee assistance programs can help employees in controlling this habit.
• Explain the relationship between mental health and tobacco, alcohol, or drug abuse.
A Sample Answer For the Assignment: HCA 250 Week 6 Assignment Substance Abuse Paper
Subjective:
CC (chief complaint): “I am scared.”
HPI: Lisa Tremblay is a 33-year-old female in a detox facility. She states that she fears getting into rehab because of what other people will think about her. She fears that people will think of her as a person with an addiction. She also worries about her business, which she says is over after operating for nine months. According to Lisa, the business collapsed because of her boyfriend, Jeremy, who took money from the account. The boyfriend spent the money to pay cocaine debts, and this caused the business to lose $ 80,000.
Lisa was introduced to cocaine by her boyfriend, who made her believe it was non-addictive. However, she developed a cocaine addiction. Lisa reports that she feels uneasy if she does not smoke cocaine. Smoking cocaine makes her feel good, and she usually wants to smoke more when the feeling of highness reduces. According to Lisa, she does not need help because Jeremy promised her that she would be okay, and she believes him because she loves him.
Past Psychiatric History:
General Statement: No psychiatric history.
Caregivers (if applicable): None
Hospitalizations: None
Medication trials: None
Psychotherapy or Previous Psychiatric Diagnosis: None
Substance Current Use and History:
Take opiates worth about $100 daily.
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Uses cannabis 1–2 times weekly.
Drinks 1/2 gallon of vodka daily. She reports drinking with her friends but states that she is in control of her alcohol consumption.
Family Psychiatric/Substance Use History: The patient’s mother has a history of agoraphobia and benzodiazepine abuse.
The father was imprisoned due to drug abuse.
The patient’s older brother has a history of opioid use.
Psychosocial History: The patient lives with her boyfriend, Jeremy, whom she reports having a
HCA 250 Week 6 Assignment Substance Abuse Paper
strained relationship with after he cheated on her. She has a daughter with an ex-boyfriend, and the girl lives with her friends. Lisa and her boyfriend had started a web design business, which collapsed after he withdrew money to pay cocaine debts.
The patient has a legal history of arrest after being found in possession of drugs. She was sexually abused by her estranged father when she was 6-9 years old. The father was incarcerated for sexual abuse and drug charges. Lisa’s mother lives in Maine. She has not heard from her older brother for ten years. She reports sleeping 5-6 hours/day, and her appetite increases when high.
Medical History: The patient has Hepatitis C. She is considering treatment for Hep C+ but needs detox first.
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Current Medications: None
Allergies: Allergic to Azithromycin.
Reproductive Hx: None
ROS:
GENERAL: Denies fever, chills, weight changes, or malaise.
HEENT: Denies eye pain, ear pain, discharge, rhinorrhea, or sore throat.
SKIN: Denies rashes, lesions, or discoloration.
CARDIOVASCULAR: Denies dyspnea, edema, chest pain, or palpitations.
RESPIRATORY: Denies wheezing, cough, SOB, or sputum.
GASTROINTESTINAL: Positive for reduced appetite. Denies abdominal pain or bowel changes.
GENITOURINARY: Denies dysuria or abnormal PV discharge.
NEUROLOGICAL: Denies dizziness, paralysis, or tingling sensations.
MUSCULOSKELETAL: Denies muscle/joint pain or limitations in movement.
HEMATOLOGIC: Denies bruising or bleeding.
LYMPHATICS: Denies lymph node swelling.
ENDOCRINOLOGIC: Denies excessive sweating, increased hunger, acute thirst, or polyuria.
Objective:
Physical exam: if applicable
Vital signs: BP-180/110; T- 100.0; P- 108; R-20; Ht- 5’6; Wt-146lbs
Diagnostic results:
ALT-168
AST-200
ALK-250
Bilirubin-2.5
Albumin-3.0;
GGT-59
Urine drug test positive for opiates, THC, and alcohol
BAL-308
Assessment:
Mental Status Examination:
The patient appears nervous and constantly fidgets and looks out through the window. She is alert and oriented to person, place, and time. Her self-reported mood is ‘worried,’ and her affect is broad. She has clear and coherent speech. Her thought process is coherent and goal-oriented. She exhibits no hallucinations, delusions, or suicidal/homicidal ideations. Memory, abstract thought, and judgment are intact. Insight is present.
Differential Diagnoses:
Substance Use Disorder (SUD): The DSAM-V criteria for diagnosing SUD include four basic categories: Physical dependence, Impaired control, Social problems, and risky use (American Psychiatric Association, 2022; Livne et al., 2021). The patient is physically dependent on cocaine and usually feels terrible when she has not smoked it. She gets high to trigger her appetite and has developed a cocaine addiction.
She also has impaired control and cannot stop using cocaine. She continues to use cocaine despite causing social problems like problems with her boyfriend and her business collapsing. Lisa spends lots of money on opiates, about $100 daily. Furthermore, she uses opiates in risky settings and has been arrested for possessing drugs.
Alcohol Use Disorder (AUD): AUD is characterized by a problematic pattern of alcohol use that results in clinically significant impairment or distress (American Psychiatric Association, 2022; Palmer et al., 2019). The patient presents with clinical features of AUD, like taking large amounts of alcohol. She reports taking 1/2 gallon of vodka daily. Besides, her urine drug test is positive for alcohol, making AUD a differential diagnosis.
Generalized Anxiety Disorder (GAD): GAD is diagnosed based on excessive, unjustified anxiety or worry, which interferes with essential activities of daily living (Boland et al., 2022; Szuhany & Simon, 2022). Lisa reports being worried about going to rehab because people will think she has an addiction. This may interfere with her treatment and recovery of opiate addiction and abuse.
Reflections: SUD is the appropriate diagnosis for this patient since she presented with a pattern of symptoms associated with using cocaine. In a different situation, I would inquire if the patient has a history of domestic violence since women who abuse substances face violence in their relationships. Legal considerations related to this patient include privacy and confidentiality. The clinician should assure the patient of confidentiality of what she says and what is recorded. Health promotion should aim to educate the patient on the effects of alcohol, cannabis, and cocaine use on her overall health.
References
American Psychiatric Association. (2022). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders
Boland, R. Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
Livne, O., Shmulewitz, D., Stohl, M., Mannes, Z., Aharonovich, E., & Hasin, D. (2021). Agreement between DSM-5 and DSM-IV measures of substance use disorders in a sample of adult substance users. Drug and alcohol dependence, 227, 108958. https://doi.org/10.1016/j.drugalcdep.2021.108958
Palmer, R. H. C., Brick, L. A., Chou, Y. L., Agrawal, A., McGeary, J. E., Heath, A. C., Bierut, L., Keller, M. C., Johnson, E., Hartz, S. M., Schuckit, M. A., & Knopik, V. S. (2019). The etiology of DSM-5 alcohol use disorder: Evidence of shared and non-shared additive genetic effects. Drug and alcohol dependence, pp. 201, 147–154. https://doi.org/10.1016/j.drugalcdep.2018.12.034
Szuhany, K. L., & Simon, N. M. (2022). Anxiety Disorders: A Review. JAMA, 328(24), 2431–2445. https://doi.org/10.1001/jama.2022.22744
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