W-10 Opiod use

Post#1 Opioid Use by Ivan

What symptoms of Substance Abuse Disorder does the individual in the video present with?

Various symptoms of the substance use disorder noted in the case study are as follows. One of them is taking a more significant number of drugs over a longer time than intended. The patient in the case study asserts that he has been taking the hallucinogenic drug to stay awake over the night in almost all the Indian ceremonies he has attended. He also reports taking Percocet or Oxycontin over an extended time to relieve pain. Another symptom that the patient in the video presentation is an intense desire or unsuccessful effort to cut down opioid use. Individuals with substance disorders find it hard to cut down the substance use once they start taking the drug (Conrod & Nikolaou, 2016). The individual in the case study finds it hard to cut down Percocet or Oxycontin. He is even coming to the provider to look for these drugs. This shows that the patient has a substance use disorder. The other symptom that the patient presents with is problems fulfilling their daily obligations both at home and the workplace. The patient in the case study asserts that he can no longer bounce like he used to. And the last symptom evident in the case study is chronic pain. Continued use of opioids can likely lead to physical problems such as chronic pain that can likely worsen the patient's conditions. The patient in the video complains of chronic pain and sweating, meaning that the continued use of opioids has declined his health condition.

What are other possible causes of his symptoms?

Some other causes of his symptoms are as follows. The first one is genetic variability. Some substance use disorders flow in the family lineage; if the parent had the condition, there is a high probability that the child too could have the disease (Patel et al., 2017). In our case study, if the patient comes from a family with opioid/substance use disorder, there is a high probability of having the condition. Another cause of the symptoms is the poor stress system response. Whenever some individuals are distressed, they are likely to turn to some drugs to relieve this stress. Some others may turn to substances such as opioids so that they can have some sleep. In the video, the patient reports having some chronic pain. The stress from such pain could expose him to opioids, eventually resulting in substance use disorder. And the last reason for the condition is prior opioid experimentation or increased exposure. This patient could have been exposed to some opioids that may have brought all these issues when growing up. In the video, the patient notes how they could take hallucinogenic drugs to stay awake all night. Such drugs could be the eventual cause of the symptoms that he exhibits.

What additional information would you like to have about this case?

Some additional information that I could have wanted to know about the case study are as follows. First, I would like to know whether any other family members have mental disorders. Some mental conditions, such as substance use disorders, run in the family (Patel et al., 2016). It is, therefore, vital to understand such data to examine how to best address the patient's condition. I would also like to know whether the patient has ever taken any therapeutic intervention in the past. The provider in the case study has done a superb job by interviewing the patient about his past medication. However, the provider fails to enquire whether the patient has ever visited a therapist. Understanding such information would help the provider know the best intervention to provide. And the last thing that I would like to know is the patient's functioning at the workplace. Understanding his functioning would help the provider examine the severity of the symptoms and the best way to address them.

Would you prescribe for this individual? Why or why not?

I would prescribe medication for this individual. But I would not prescribe the medicines (Percocet or Oxycontin) that he talks about it. Instead, I would give him a medication that helps would help him manage the pain and treat the drug addiction. One of the medications that would greatly help do this is methadone. Prescribing this medication would help relieve pain as well as manage other symptoms of opioid mental disorder.

What would your next steps be for this individual? What would your treatment plan be?

The treatment plan for this individual would incorporate both psychotherapy and pharmacotherapy. Psychotherapy that would best address the symptoms of the patient is motivational interviewing (MI). MI is a patient-centered approach that helps individuals find the motivation to make a positive behavior change (Madson et al., 2016). The method is mainly used on patients who have mixed feelings about changing their behaviors. When offering the intervention, I would apply various MI concepts, including evocation rather than education, rapport, and empathy, to help the patient develop his problem. Besides, I would incorporate methadone in the treatment plan to alter the patient's behaviors, i.e., addiction, and relieve his pain. To manage the disorder, the patient should take 2.5 mg PO q8-12hr, titrated slowly with dose increases no more frequent than every 3-5 days. This synthetic opioid agonist medication eliminates pain and relieves drug cravings by acting on opioid receptors in the brain (Murphy, 2018). However, before administering the medication (Methadone), the provider should monitor Urine, saliva, hair, and blood tests to detect the presence of drugs in the patient's system.

References

Conrod, P., & Nikolaou, K. (2016). Annual Research Review: On the developmental neuropsychology of substance use disorders. Journal of Child Psychology and Psychiatry, 57(3), 371-394.

Madson, M. B., Schumacher, J. A., Baer, J. S., & Martino, S. (2016). Motivational interviewing for substance use: Mapping out the next generation of research. Journal of Substance Abuse Treatment, 65, 1-5.

Murphy, M. (2018). Blueprints psychiatry. Lippincott Williams & Wilkins.

Patel, V., Chisholm, D., Parikh, R., Charlson, F. J., Degenhardt, L., Dua, T., ... & Whiteford, H. (2016). Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities. The Lancet, 387(10028), 1672-1685.