Drug and substance abuse counselors serve a crucial role in freeing addicts from substance abuse. They play a key role in offering useful knowledge to drug and substances addicts and hence help the addicts in taking important steps towards arriving at a life free from drug and substance abuse. Ann, a twenty six year old black female is an example of a client who is entirely in need of a specialized counselor in order to be guided towards rehabilitation from her current state of marijuana and opioids addiction. Ann has been abusing marijuana for six year and has been using opioids in pill form for two years. Being a single woman, Ann is heterosexual and often engages in sex trading. Her habit of purchasing opioids from unknown sources means that she is in a serious situation of drug addiction and has strong secret links with drug traffickers. Ann is reported to have increased her marijuana and opioids intake amounts and has increasing tolerance. Her diagnosis is substance use disorder and a counselor handling Ann’s case of drug addiction has to perform a number of core functions in order to help her recovery become more effective and successful.
Core Functions
The first core function is patient screening ( Loverde, 2013 ). In this regard, a counselor examining Ann in an endeavor to decide whether to admit her for treatment or not has to consider the following information regarding her: Ann is twenty six years old female; she is single; and has no children. This means that Ann is eligible for rehabilitation. However, there are some factors that may limit Ann’s rehabilitation. For example, Ann is in part-time employment meaning she has no stable source of income to cater for her medication. In addition, Ann has been abusing marijuana for six year; meaning her condition is hard to correct. Besides, Ann has been increasing amounts of opioids and her tolerance is also increasing; further making her rehabilitation difficult to curb.
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The second core function is patient intake; where the counselor should fill out the vital documentary regarding the client as well as examining the technical admission aspects ( Loverde, 2013 ). In this case, the counselor should guide Ann is signing consent forms to help in protecting her confidentiality regarding her rehabilitation on marijuana and opioids usage ( Loverde, 2013 ). The next core function to undertake is patient orientation; where the counselor should establish the goals and the nature of Ann’s treatment ( Loverde, 2013 ). For instance, Ann must be warned against behavioral acts, such as sex trading and secret purchase and usage of opioids and marijuana, as such habits limit her recovery. She should be kept under protection and away from possible access to marijuana and opioids in the course of the treatment.
Counseling is another vital core function that should be instilled on Ann ( Loverde, 2013 ). Under this core function, the counselor should offer both Ann and her parents with therapeutic advice to help them in arriving at substantial solutions to Ann’s treatment and implementation of her treatment plan ( Loverde, 2013 ). After counseling, the drug and substance abuse counselor should proceed to case management process ( Loverde, 2013 ). This is aimed at arriving at predetermined framework of action through bringing people, services, and agencies together in order to determine both short-term and long-term goals of the client ( Loverde, 2013 ). Thus, the counselor should guide Ann in fully understanding her best course and goals of the rehabilitation program.
Crisis intervention is another core function that the counselor needs to put into consideration ( Loverde, 2013 ). Given that Ann is a serious addict of marijuana and opioids, her rehabilitation would mean that she will have to face serious withdrawal effects, such as drug relapse and acute emotional and physical distress ( Loverde, 2013 ). Thus, the counselor ought to deploy immediate course of action to quickly contain any withdrawal effect that Ann may face during the rehabilitation process, and develop a good plan in keeping Ann free from any recurring situation of withdrawal effects. Patient assessment is another vital step that the counselor needs to conduct on Ann treatment ( Loverde, 2013 ). In this regard, the counselor should make one-on-one meeting with Ann in an endeavor to interview and obtain the vital information useful in Ann’s treatment program ( Loverde, 2013 ). For instance, the counselor needs to establish Ann’s points of strengths and weaknesses, as well as determining the challenges that Ann may face during the process of treatment.
The next core function is treatment planning ( Loverde, 2013 ). Under this function, the counselor should clearly bring out a well-set plan of treatment goals and assessment results regarding Ann ( Loverde, 2013 ). Where possible, the counselor should closely involve Ann in arriving at the best treatment plan, with respect to her current state of part-time employment and financial status. In the case where Ann fails to meet her treatment expenses, her parents should be consulted for financial support. The counselor should also use a treatment language that is conversant to Ann in order to ensure that she follows every aspect of treatment. Ann also needs to be kept under intensive educational programs ( Loverde, 2013 ). For instance, she needs to be taught on the dangers of marijuana and opioids use. Ann needs to be educated on the importance of marriage and the dangers posed by sex trading. In addition, Ann needs to be kept conversant to the best practices that may facilitate her recovery, such as attending religious functions.
Another core function is referral. This happens when a counselor realizes that the client requires a higher specialized attendance, or the facility being used has no enough equipment to offer the best recovery to the patient ( Loverde, 2013 ). Ann may need referral to highly specialized counselors due to three reasons. First, she is in serious condition of addiction; she has been on marijuana for six years. Secondly, Ann is becoming tolerance to opioids and her amounts are increasing. Finally, Ann has been engaging in sex trade and therefore, need to be handled by highly specialized personnel. Besides, the counselor needs to maintain accurate record-keeping and reporting with regards to Ann’s treatment ( Loverde, 2013 ). This may involve tracking Ann’s progress of treatment from the time of assessment to the time she is discharged. The final core function is cross-consultation ( Loverde, 2013 ). Ann is in critical conditions of addiction, tolerance, and increased amounts and therefore, her treatment may need a wide variety of consultations from other specialists in order to ensure maximum care and quick recovery.
Case Analysis and Discussion
Based on the case study, Ann has various conditions which indicate that her life is in danger. First, Ann started abusing marijuana at the age of 18. Secondly, Ann has been using opioids in pill form for a period of two years, and she has been increasing the opioids use with time. This is a clear indication that she is absolutely addicted to marijuana and opioids. Based on the American legislative law, Ann has no the right to refuse care and treatment because her condition is a threat not only to her life, but also to the well-being of the surrounding community ( Torrey, 2019 ).For instance, abuse of marijuana and the opioids may cause health issues to Ann and also act as a threat to the community, as she may develop criminal acts, such as rape cases, robbery, stealing, and violence. In this regard, it is necessary for the health care professionals to consider Ann for intensive health care and rehabilitation to help her recover from her addiction. However, a question may arise on whether Ann has the right to refuse treatment. A patients’ right to refuse treatment is considered valid if and only if the concerned patient has full access to informed consent ( Torrey, 2019 ). This means that the patient has full knowledge on his or her treatment options that are available and understandable to the patient ( Torrey, 2019 ). Therefore, Ann needs to be given full knowledge regarding her recovery options and be given the opportunity to choose the best option for her treatment; considering that she is on part-time employment. In the case where Ann may not be able to make the right decision regarding her treatment, the health care professional should engage her parents ( Torrey, 2019 ). Therefore, Ann should be considered as in treatment client.
Based on the clinical ethics, the health care providers have the moral obligations to always ensure that they provide optimum care for their patients (White et al., 2005). Therefore, considering Ann as an out of treatment patient would be against the clinic ethical values and standards for a number of reasons. First, much as Ann may be experiencing increased tolerance, she is entirely in need of the counselor’s assistance to help her control her addictive status (White et al., 2005). This is because Ann is out of control of her current status of marijuana and opioids abuse and she needs to be assisted by all means to fully contain the habit. She therefore, has no ability to make her decision regarding her treatment and the health care provider should engage her parents in helping Ann to make the right decision.
Secondly, in the case where Ann may show no signs of recovery, due to her prolonged usage of marijuana, she should be given enough time to recover from her addictive state. This is because Ann’s ability to regain her control over the usage of marijuana and opioids may take time, as she may experience episodes of relapse (White et al., 2005). Therefore, showing no signs of recovery, at the initial stage, should not be taken as a reason to impute administrative discharge on Ann, as she still has the opportunity to make gradual recovery. Finally, the fact that Ann has been on marijuana for a long time, means that she has to go through long-term recovery process; which requires ultimate support from both the health care professionals and the family members (White et al., 2005). Opting for administrative discharge on Ann would therefore, be more of punitive measure to her, as she has the right to receive the best treatment, just like the other citizens of the nation. Ann should therefore, be considered as in treatment client and should not be abandoned.
Based on financial needs, American citizens may choose to opt out of treatment if they know that the treatment is likely to have negative impacts on their financial status ( Torrey, 2019 ). As for the case of Ann, recovery from marijuana and opioids usage may be not affordable to her for some reasons. Ann is on a part time employment and may not be able to raise enough money to fund her clinical bill. Secondly, there is no indication that she has any medical cover, either from her side or from her parents’ side. Lastly, Ann’s recovery would mean that she goes through a long period of treatment. This means that she will require admission to the health care facility, and will therefore, not be able to attend to her job; meaning her source of income will be altered.
Because of her financial needs, Ann will be likely considered out of treatment. However, considering Ann out of treatment would do more harm than benefit. For instance, Ann will continue abusing the marijuana and opioids and her case will continue worsening and finally reach beyond control. Furthermore, as she continues using marijuana and the opioids, she will continue misusing her little income on the purchase of the drugs and will finally be unable to raise funds for her basic needs. Therefore, whether she is considered for in treatment or not, Ann will finally fall broke and face even more difficulties in life; further prompting her to commit crimes, such as theft, robbery, or intensifying her sex trading; which may lead to spread of sexually transmitted diseases, both to her and to the society at large. This means that Ann should be assisted by both her parents and the government to go through rehabilitation process in order to avoid worse reputations in the future.
Diagnosable Drug Use Disorder
This article will use the term “diagnosable drug use disorder” to refer to the abnormalities accruing from the use of the top ten classes of the commonly abused drugs, namely: alcohol, opioids, caffeine, hallucinogens, inhalants, sedatives, cannabis, hypnotics, stimulants, and tobacco (Hartney & Gans, 2019). These drugs and other substance abuse have the ability to activate the brain’s reward system and cause negative effects to the well-being of the body organs (Hartney & Gans, 2019). It is also worth to note that these drugs, commonly known as the DSM5, affects individuals at varying degrees; some individuals have high resistance to the development of the substance-related disorders, while others are highly vulnerable to the development of the drugs and substance-related disorders upon exposure to the drugs (Hartney & Gans, 2019).As for the case of Ann, she is highly vulnerable to several drug disorders.
One of the disorders that Ann has developed is prolonged usage of marijuana and increasingly abuse of opioids (Mclellan, 2017). Secondly, Ann may be willing to stop the habit of marijuana and opioids use, but she may be unable to stop due to their high addictive power (Mclellan, 2017). Thirdly, if Ann may opt to undergo treatment in an attempt to rehabilitate from the marijuana and opioids usage, her recovery may be gradual and may take a long time (Mclellan, 2017). The fourth indicator that Ann is on drug disorder is her act of engaging in sex trade (Mclellan, 2017). This is an indication that she has given up her social dignity due to the marijuana and opioids usage. The last indicator that Ann is on drug disorder is her increased tolerance (Mclellan, 2017). This is shown by the fact that Ann started using marijuana from the age of 18 to the age of 26 and she has in addition been using opioids for the last two years.
Comorbidity
This paper will use the word comorbidity to refer to a situation in which a client displays additional distinct clinical entity that may coexist or may arise in the processes of medical cause ( Hall, Lynskey, & Teesson, 2001 ). For the case of Ann, comorbidity may manifest in two ways. To start with, the recent habit of Ann’s usage of opioids may be closely linked to her previous usage of marijuana. For instance, it is indicated that Ann purchases opioids from unknown source. This implies that she is properly linked to drug dealers who might have introduced her to her recent usage of opioids. Next, Ann’s recent engagement in sex trading may be blamed on her drug and substance abuse. Ann has been on marijuana since the age of 18 and has been using opioids for the last two years. Given that Ann has no stable source of income, she may opt for sex trading in order to get money for the purchase of the drugs. This explains why she is not married and has no children.
Drivers of the Ann’s Addition
There are various factors that may have contributed to Ann’s current states of marijuana and opioids addiction. The first contributor is psychological factors ( CASAColumbia, 2012 ). Ann is likely to be in deep distress due to lack of good source of income and loneliness, as she is not married and has no children. The second factor is genetic predisposition ( CASAColumbia, 2012 ). For instance, Ann might have inherited the habit of marijuana intake from her parents ( CASAColumbia, 2012 ). No wonder Ann started using marijuana at the age of 18. In addition, it is evidence that Ann could be having certain brain characteristics that trigger her addictive state ( CASAColumbia, 2012 ). This is indicated by her increased tolerance to opioids.
Conclusion
In conclusion, Ann is an addict of both marijuana and opioids. She has been using marijuana for a period of 8 years and has been on opioids for the last two years. Although Ann may appear out of treatment, it is necessary that she should be considered as a client in treatment, just like any other citizen. This is because her state is worsening and there is need to be controlled in time before it reaches beyond uncontrollable level. The law holds that all citizens have the right to be considered for in treatment regardless of their gender, age, and ethnicity; and therefore, Ann should be put under treatment with immediate effect. This article has established that Ann is vulnerable to drug disorders, such as long-term usage and addiction. The comorbidities surrounding Ann include sexual trading in order to earn money for the purchase of marijuana and opioids; and opioids tolerance due to prolonged usage of marijuana. Besides, the paper has established that Ann’s key drivers of addiction are the psychological factors and family history.
References
CASAColumbia. (2012). Addiction Medicine: Closing the Gap between Science and Practice.
Hall, W., Lynskey, M., & Teesson, M. (2001). What Is Comorbidity And Why Does It Matter? In M. Teesson & L. Burns (Eds): National Drug Strategy: National Comorbidity Project, National Drug And Alcohol Research Centre, University Of NSW, Sydney.11-12.
Hartney, E, & Gans, S. (2019). DSM 5 Criteria for Substance Use Disorders. (Online).Retrieved from https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorders-21926
Loverde, M. (2013). What are the 12 core functions of a drug and alcohol counselor? Addiction hurts, we can help. 1(888): 283-3576.
Mclellan, AT. (2017). Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare? Trans Am Clin Climatol Assoc. 128:112-130.
Torrey, T. (2019). Do Patients Have the Right to Refuse Medical Treatment? (Online).Retrieved from https://www.verywellhealth.com/do-patients-have-the-right-to-refuse-treatment-2614982
White, W., Scott, C., Dennis, M., & Boyle, M. (2005). It’s time to stop kicking people out of addiction treatment: Counselor. 6(2): 12-25.
