In recent years, cases of mental health diseases have risen significantly in the United States and globally. Mental health conditions are escalating every day, and if nothing is done, the number is expected to rise further in the coming year. Statistics by Mental Health and Addiction Insurance Health (MHIA) shows that approximately one out of ten American adults addicted to substance use has a higher risk of mental disorders like depression and a mood disorder ( Kassen, 2016). In most cases, mental illnesses are comorbid in alcohol and substance use. Mental disorder and comorbidity of substance abuse can worsen each other course. Drug addiction is regarded as a mental health condition because it can change one's brain leading to compulsive behaviors, thus weakening the person's ability to control her impulses and eventual hallmark to mental disorders. The symptoms of substance abuse are similar to that of mental conditions. In addition to that, predisposing genetic vulnerabilities can lead to individuals' susceptibility to both substance abuse and mental illness. Other possible comorbidity contributors include trauma and stress, such as physical and sexual abuse. Study indicates that men are susceptible to commodity addiction compared to women because they are more prone to antisocial tendencies. With increasing comorbid addiction cases, there is a need to develop ways of controlling such habits to handle rising mental health diseases. This essay will discuss the medication's decision to be prescribed to a 53-year old Puerto Rican female who has been diagnosed with comorbid addiction. The paper will further discuss the impact of ethical consideration on her treatment.
Decision Point One
Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every four weeks
Reasons for selecting the decision
The decision was selected because mental disorders are associated with drug abuse. Besides, mood fluctuations and bipolar disorders have been observed among alcohol and substance use. In some cases, substance use can affect neurotransmitters in the brain, thus resulting in psychiatric conditions. Therefore, the medication is for this patient is Naltrexone (Vivitrol) injection with a combination of lithium; the drug will improve his moods and relieves her from drinking alcohol. According to Zanni et al. (2019), lithium is effective in women undergoing fast mood changes. Therefore, it effectively alleviates mood when used alongside naltrexone; the combination will reduce her craving for alcohol. Generally, the medication will help control addiction problems and improve the perspective of the client.
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Different between the expected outcome and actual result
According to the result, the client is still smoking and has reported a problem with anxiety. After four weeks, the client returned to the clinic and indicated that she does not do to casino frequently but still spend a lot of money gambling. Besides, she still smokes and experiences some anxiety. The difference between the result of decision one and the expected outcome is that Mrs. Perez complained of tremors and weight gain. To address the side effect, the doctor suggested a medication that could handle the anxiety issue.
Decision point two
Add on Valium (Diazepam) 5 mg orally TID/PRN/anxiety
Reasons for selecting the decision
According to the result obtained in decision one, the client indicated that she had gained weight after four first treatment weeks. The client was still smoking and experiencing anxiety. The decision was chosen because Mrs. Perez is still having a problem with anxiety and weight gain. According to Airagnes et al. (2019), Valium is used to treat alcohol withdrawal, seizures, and anxiety. Besides, the medication help to relieve muscle spasms. Based on the previous, anxiety and weight gain were one of the side effects of medication. Therefore, using Diazepam would help control stress and reduce weight gain. Besides the side effects of the drugs, the continued use of alcohol also results in weight gain. Therefore, the drug used must have minimal weight gain and work to decrease the already high weight.
Different between the expected outcome and actual result
After four weeks, the client returned to the clinic and reported that the anxiety had gone. But based on her statement, the client was still experiencing mood swings. In addition to that, she had started going to local gambling meetings. The medication used was expected to control anxiety and reduce weight gain. In the case of comorbid addiction, Valium would be useful in reducing weight gain. Most of the predicted outcome was met except for the moods. The patient had recorded weight loss and decreased craving for alcohol. The only challenge is that the client's mood was still unstable.
Decision point three
Continue the current dose of Vivitrol, increase Valium to 10 mg orally TID/PRN/anxiety. Refer to counseling for her ongoing gambling issue.
Reasons for selecting the decision
The client returned to the clinic after fours week and reported a massive improvement. She was impressed by her progress and requested if the valium dose could be improved. The decision was picked because the client had recorded an immense improvement, and therefore continuing with the medication would lead to further progress. The most suitable action for the patients was to continue with the Vivitrol and reducing Valium to discontinue the drug in the coming two weeks ( Goodlet et al., 2019). The side effect of Vivitrol needed to evaluate to find whether the effects persisted.
Different between the expected outcome and actual result
The client can be referred to counselors who will help her control her gambling addiction, which is also a hidden factor. At this point, no medication should be added to treat the side effects of the existing drug unless the side effect is considered transient. In such cases, benzodiazepines can be used. But precautions should be taken in a case where the client is experiencing addictive multiple disorders. In case the client continues with the gambling, she should be referred to a counselor specializing in gambling disorders treatment.
Impact of ethical considerations on the treatment plan used and communication to the patient.
The client is likely to face an ethical challenge associated with the treatment of alcohol use and comorbid substance addiction. Moral considerations arise from there are adverse treatment systems that address drug use disorders and mental conditions ( Anderson and McNair, 2018). Manu physicians are at ease of treating mental illnesses, but they are challenges in treating drug abuse use due to background-related factors. Some physicians associated drug use with societal problems, thus feeling uneasy to address the issue. Furthermore, drug abuse centers have few qualified personnel and treatment programs to monitor substance abuse users with mood disorders. Failure to address the problems have made it escalate to comorbidity addiction.
Conclusion
In conclusion, patients with mental disorders and substance abuse problems face difficulties in treatment as they experience severe addiction and exhibit persistence. Besides, they are at high risk of developing an addiction to comorbid mood problems. However, various treatment options are emerging to address the rising cases of substance abuse and addiction to comorbid mood problems. The medications are based on the patient's physical condition, such as mood disorders and weight.
References
Airagnes, G., Ducoutumany, G., Laffy-Beaufils, B., Le Faou, A. L., & Limosin, F. (2019). Alcohol withdrawal syndrome management: Is there anything new?. La Revue de medecine interne , 40 (6), 373-379.
Anderson, E., & McNair, L. (2018). Ethical issues in research involving participants with opioid use disorder. Therapeutic innovation & regulatory science , 52 (3), 280-284.
Goodlet, K. J., Zmarlicka, M. T., & Peckham, A. M. (2019). Drug–drug interactions and clinical considerations with co-administration of antiretrovirals and psychotropic drugs. CNS spectrums , 24 (3), 287-312.
Kassen, J. (2016). Beyond Burnout: Educators' Experiences of Mental Health Issues, and Stigma in the Workplace.
Zanni, G., Goto, S., Fragopoulou, A. F., Gaudenzi, G., Naidoo, V., Di Martino, E., ... & Merino-Serrais, P. (2019). Lithium treatment reverses irradiation-induced changes in rodent neural progenitors and rescues cognition. Molecular Psychiatry , 1-19.
