Jessica Doe appears disheveled and malnutritional. Her body seems to be underweight and unhealthy. Doe’s hair is unkempt, with indications of hair loss. She seemed confused and disoriented during the assessment. In addition, the patient cannot maintain eye contact during the interviews. This patient cannot respond to greetings or everyday conversation. Doe appears to have bark spots and rashes on her skin. She has multiple scars, some that appear healed and others fresh. Doe has dental issues like evident tooth decay.
Apparent Symptoms
Doe has challenges with her verbal and non-verbal communication. For example, she experiences challenges when describing her condition. She appears disoriented and needs help to understand the questions asked. The patient cannot respond clearly to verbal and non-verbal cues used during the assessment. This patient cannot converse sensibly or make critical decisions based on her surroundings. Instead, she depends on her relatives for support and care.
In addition, Doe appears anxious and irritable. For instance, she hesitates to provide accurate information and seems distressed. During the assessment, Doe appeared to mistrust the medical practitioner. She feels anxious about the unfamiliar hospital environment. Further, Doe is irritated with the lengthy evaluation at the clinic. She cannot control her emotions effectively as she interacts with medical practitioners. Other symptoms include blurred vision and the inability to perceive numbers and letters correctly.
Client Description
Jessica Doe is a 30-year-old Caucasian female who identifies as heterosexual. She has a middle-class socioeconomic status. She comes from a family that owns a home and a car. Her parents and siblings have attained a minimum of a college education. Doe’s family has a stable income and health insurance coverage. Although Doe struggles with addiction, she is a college graduate who has steady employment. However, she is dependent on her family for basic needs and medication.
Required Assessment
Doe requires a comprehensive assessment to determine her proper diagnosis. This assessment will include a clinical interview to gather detailed information about her substance use history, family history, mental health, and social support. In addition, this patient requires a physical examination to ascertain the presence of any health issues related to substance misuse. The healthcare professional will conduct a psychological assessment using the validated assessment Addiction Index (ASI) and the Substance Abuse Subtle Screening Inventory (SASSI). These tools will help assess the severity and nature of substance use.
Client’s Drug Choice
The findings from the assessment reveal that Doe craves to use alcohol and neglects her social status. Although Doe has expressed the desire to stop using alcohol, she experiences intense cravings. Her previous efforts to prevent alcohol use were unsuccessful. The patient uses alcohol in more significant amounts than she intends. The situation persists despite her behaviors causing social problems like failed relationships with her parents, siblings, and friends. The continued alcohol abuse has forced Doe to neglect other parts of her life. Also, she continues to use alcohol despite the increased health and safety risks. These factors imply that Doe’s alcohol choice meets the criteria for substance use disorder.
Patient’s Diagnosis
Does show symptoms that justify the presence of substance use disorder for alcohol. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) shows that alcohol withdrawal and generalized anxiety disorder are attributable to drug use disorder rather than other health conditions (American Psychiatric Association, 2013, p. 558). The patient experiences withdrawal symptoms from her attempts to stop using alcohol. Besides, her current situation reveals a manifestation of anxiety syndrome. The onset of these conditions implies that Doe requires support to address her current needs and avoid a possible relapse to alcohol use. Substance use disorder includes a constellation of mental, behavioral, and physical symptoms associated with continued substance and drug abuse (American Psychiatric Association, 2013, p. 483). Doe continues with excessive alcohol use despite her impaired cognitive abilities and deteriorating physical health. These conditions justify that Doe requires clinical support to stop excessive alcohol use. Hence, Doe qualifies for treatment of alcohol use disorder.
Theoretical Application
The biopsychosocial model is applicable in explaining Doe’s substance use disorder. The biopsychosocial model postulates that substance use disorder involves a set of mental and behavioral features that result from the development of tolerance psychological, and physiological dependence (Cataldo et al., 2019, p. 2). Psychological and social factors influence people to engage in specific substances or drug abuse. In this case, addiction occurs through a negative or positive reinforcement mechanism. For instance, positive reinforcements happen when the first drug or substance consumption leads to a reward (Cataldo et al., 2019, p. 2). Pleasurable experience with drugs or substances increases the likelihood of continued consumption. Negative reinforcement occurs when people with addiction use drugs to soothe the aversive withdrawal symptoms (Cataldo et al., 2019, p. 2). People with negative reinforcement require adequate support to overcome their addiction and associated adverse outcomes. The biopsychosocial model is appropriate for explaining how Doe experienced addiction problems and the manifestation of withdrawal symptoms, which increases the risk of health problems.
Psychological factors and social environment contribute to Doe’s substance use disorder (SUD). Guinle (2020) considers stress and trauma as important cues of drug addiction among women (p. 2). There is a possibility that stress and trauma motivated Doe to engage in alcohol. The positive reinforcement from alcohol, which allowed Doe to forget or relieve her stress and trauma, resulted in addiction. Besides, peer pressure and a family history of addiction are essential factors that contribute to substance use disorders (Holzhauer, 2020, p. 4). This observation implies that Doe may have experienced social pressure from her alcoholic peers, which sparked her drinking behavior. In addition, growing up in a family with a history of addiction created a positive reinforcement for Doe to engage in sustained alcohol use. Doe continued with alcoholism despite the manifestation of adverse health outcomes to suppress withdrawal symptoms. Therefore, psychological and social factors contributed to the current Doe’s alcohol addiction through positive and negative reinforcement.
Impairments and Detrimental Impacts
Continued alcohol use has detrimental health and social impacts. Doe’s inability to overcome her addiction causes problems at individual, family, and community levels. The following are the undesirable outcomes of Doe’s alcohol use disorder.
Individual Level
Doe’s physical health continues to deteriorate due to chronic alcohol use. She suffers from severe anxiety and depression, exacerbated by her substance misuse. As a result, this patient experiences a significant loss of self-confidence and self-worth, leading to a sense of hopelessness. Also, Doe patient experiences deteriorating physical health characterized by malnutrition and sustained weight loss. The deteriorating health continues to impose avoidable financial constraints.
Family Level
Doe’s addiction has severely affected her family. For instance, Doe’s parents feel emotionally drained from their efforts to help her in overcoming addiction. Doe’s siblings have distanced themselves from her due to her unpredictable behavior. Her partner has left her because of his inability to cope with her addiction and its undesirable social consequences. Also, Doe’s family experiences financial constraints as they struggle to seek clinical interventions.
Societal Level
Doe’s addiction caused her to lose her job, which has added significant financial strain to social welfare systems. Doe’s struggles with alcohol resulted in multiple accidents, further burdening healthcare resources. These incidents have demanded increased attention from law enforcement. Collectively, these challenges underline the extensive societal impact that her addiction continues to impose on society.
Treatment Recommendations
Doe’s case requires a comprehensive and tailored approach to ensure a sustainable solution. The intervention should focus on her substance misuse issues and consider the other factors that shape her identity. An intervention that addresses addiction and social elements can be more effective in supporting Doe’s recovery and overall well-being. The primary objective is to prevent Doe from a possible relapse to alcoholism.
Detoxification
Doe will require an immediate medical detox to manage withdrawal symptoms. Detoxification is an essential part of managing alcohol disorders that helps to diminish drinking cues (Mutter & Ali, 2019, p. 53). Detoxification will assist Doe in avoiding the tendency to drink as a way of relieving himself from undesirable withdrawal symptoms. In addition, detoxification will prevent a possible onset of undesirable health outcomes. For instance, alcohol withdrawal may lead to health complications like fatal seizures and delirium tremens (Mutter & Ali, 2019, p. 53). Detoxification is essential in minimizing the risk of the onset of these symptoms. Therefore, Doe will benefit from an immediate detox in managing her withdrawal symptoms and preventing a possible start of undesirable health outcomes.
Counseling
Jessica will participate in individual and group therapy to address the psychological aspects of her addiction. Client-centered counseling interventions help promote behavioral change (Knox et al., 2019, p. 6). The individual therapy sessions will support Doe in exploring and resolving doubts about her ability to manage addiction. Group therapy sessions will help enable Doe to interact with other peers who have completed or are undergoing treatment. This strategy will ensure that Doe receives the required moral and social support to overcome her addiction.
Medication-Assisted Treatment (MAT)
The medical team will consider MAT to support abstinence from alcohol. Knox et al. (2019) recommend medications such as disulfiram, naltrexone, and acamprosate as suitable medications to manage alcohol addiction (p. 8). The physician will determine the most appropriate medication for Doe’s health needs. Doe’s parents will ensure that she takes and completes the prescribed tasks appropriately.
Family Therapy
The medical team will involve her family to address codependency and support her recovery. According to Knox et al. (2019), involving spouses and other family members of an alcoholic adult in treatment efforts enhances the outcomes (p. 7). Engaging Doe’s relatives in the counseling sessions will help ensure that she receives adequate support in overcoming her addiction problem. Her relatives will learn practical ways to ensure that Jessica does not relapse from her addiction.
Social Support
The medical team will connect Doe with peer support groups to enhance her social network. Social support groups will provide Doe with the required moral support to avoid reverting to alcohol use. The psychologists handling Doe’s case will connect her to local social groups where she can interact with other reformed addicts. This intervention will ensure that Doe finds new hobbies and activities that can distract them from possible alcohol addiction.
Identity-Specific Interventions
The physicians will tailor Doe’s treatment to meet her unique needs based on her gender identity and ethnicity. Being a female heterosexual, Doe may experience discrimination due to her alcoholism. Most people disregard alcoholism among women, which may hinder Doe from accessing adequate social support. The physician will collaborate with Doe’s family to design specific services to address possible social stigma preventing Doe from achieving desirable outcomes.
Holistic Wellness
The physician will encourage Doe to participate in physical fitness and mindfulness practices. Doe’s family will participate in implementing her physical and mindfulness program to ensure consistency and efficiency. Doe’s parents will review her progress to assist the physician in identifying possible gaps and changes that can improve the overall outcomes.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th edition). American Psychiatric Publishing.
Cataldo, I., Azhari, A., Coppola, A., Bornstein, M. H., & Esposito, G. (2019). The influences of drug abuse on mother-infant interaction through the lens of the biopsychosocial model of health and illness: A review. Frontiers in Public Health, 7(45), 1–8. https://doi.org/10.3389/fpubh.2019.00045
Guinle, M. I. B. (2020). The role of stress, trauma, and negative affect in the development of alcohol misuse and alcohol use disorders in women. Alcohol Research: Current Reviews, 40(2), 1–17. https://doi.org/10.35946/arcr.v40.2.05
Holzhauer, C. (2020). Sex and gender effects in recovery from alcohol use disorder. Alcohol Research: Current Reviews, 40(3), 1–19. https://doi.org/10.35946/arcr.v40.3.03
Knox, J., Hasin, D. S., Larson, F. R. R., & Kranzler, H. R. (2019). Prevention, screening, and treatment for heavy drinking and alcohol use disorder. The Lancet Psychiatry, 6(12), 1–36. https://doi.org/10.1016/s2215-0366(19)30213-5
Mutter, R., & Ali, M. M. (2019). Factors associated with completion of alcohol detoxification in residential settings. Journal of Substance Abuse Treatment, 98, 53–58. https://doi.org/10.1016/j.jsat.2018.12.009
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