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Substance Use Disorders

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Read the following two case scenarios:

Initially, Jose used cocaine only on the weekends when he was out with friends. But now he uses it every day, even when alone. Jose spends nearly his entire paycheck on his cocaine use. His wife is threatening to divorce him, and he is close to being fired from his job for underperforming. Yet, he continues to use cocaine.

Steven suffers from Attention Deficit/Hyperactivity disorder.  In order to help him focus better at work, Steven’s doctor prescribed Adderall (amphetamine).  Initially, Steven noticed an improvement in his concentration at work.  After he had been taking Adderall for 6 months, however, recently he is starting to feel his concentration slipping again. He mentioned this to his doctor, and his doctor increased the dosage Steven was taking.  He has also noticed that if he forgets to take his medicine, he is very tired, feels depressed, and has trouble sleeping.

Based on your readings, what is your viewpoint regarding Jose’s and Steven’s substance use? Keep the following questions in mind while writing the paper:

  • What category of substances do cocaine and amphetamine fall under, and what are the implications of this category on the body?  Be sure to give the classification, DEA schedule, and physical effects.
  • How is a substance use disorder diagnosed?
  • Is Jose’s behavior evidence of a substance use disorder? Give a clear and thorough rationale for your response.
  • Is Steven’s behavior evidence of a substance use disorder? Give a clear and thorough rationale for your response.

Before responding to the questions, read the information on this Web site:

http://www.drugabuse.gov/sites/default/files/cocainerrs.pdf

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In completing the case study, students will be addressing the following learning objectives:

Identify the two main components of interdisciplinary treatment for clients with substance abuse disorders.

Explain the importance of recognizing co-occurring disorders.

1. John, a 23-year-old unemployed man, is addicted to cocaine. John lives with his mother and sister and has been stealing money from them to pay for his cocaine. His mother persuaded John to voluntarily commit himself to the hospital for treatment of his substance abuse. In the initial assessment interview, the nurse learns that John began smoking marijuana at age 19 and occasionally consumes alcohol. John said that he started on cocaine after his father, who had a history of alcoholism, committed suicide. John says that he began to feel anxious then and still has periods of anxiety. John is cooperative with his treatment program and stated that he wants to get completely off drugs and get a good job to help his mother and sister. John also said that if he experienced anxiety, he would take a stiff drink like his father had done when he was anxious.

(Learning Objectives: 2)

a. How can the psychiatric staff counsel with John to avoid his turning to alcohol as substance?

b. With what other co-occurring disorders could John be diagnosed?

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