The Diagnostic Statistical Manual (DSM 5) is the 5 th Edition of the American Psychiatric Association book that acts as a diagnostic guide tool. Before being diagnosed with a disorder, a substance use individual has to meet some criteria and should match within the past twelve months. It is important to note that a symptom is only considered when it causes stress or impairment to the user. One is the recurrent use of a drug or substance in even situations that are very risky, for example, when operating heavy machinery (Nuccols, 2013). Consequent use of the drug poses a lot of challenges to the user since they fail in fulfilling significant responsibilities either at home, work or school. The individual’s craving for the drug or substance is very high.
Another symptom is the continued use of substance despite knowing the effects linked for example damaged social relations. An individual developing drug tolerance towards a specific drug and needing more of the drug to experience the same effects is also a symptom. Withdrawal symptoms are associated with the drug after cessation of using it or in another case the individual uses substitute drug. An individual taking more drugs than they had planned or consuming the same drug for a longer period than they had planned is also another symptom (Nuccols. 2013). Having a persistent urge to cut down on taking or having the desire towards a drug rates also links up to the symptoms. Symptoms of spending a lot of time in using the drug, recovery from the drug or doing the respective job needed in getting the drug and replacing important events, for example, social interaction or recreational activities with drug use may be observed. The final symptom is, the continuing use of a drug despite the fact that the individual knows that the drug causes or worsens a particular mental or physical health situation.
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When it comes to the consideration of substance use disorders DSM- V has undergone few changes from the DSM-IV model. As opposed to edition IV whereby it classified substance use disorder into abuse and dependence, the new DSM-V only classifies the disorders into substance use disorder. According to DSM-IV an individual either had a disorder or not but in DSM-V an individual disorder can be termed as mild, moderate or severe. The new version gives consideration on the severity of a disorder (Nuccols, 2013). Finally, in the older version of DSM, a person only had to show one inherent symptom for a diagnosis of substance while in the new version for a person to be diagnosed with a disorder an individual had to show at least two symptoms.
Scoring on the DSM V is based on the meeting the criteria symptoms. If one identifies zero or one of the criteria, the person is not said to be meeting the required threshold for disorder diagnosis. When an individual meet two or three of the criteria, he or she termed to have mild substance use disorder. When the individual meets four or five criteria the person is said to have moderate substance use disorder and if they meet more than six of the criteria, the substance use disorder is termed as severe (Nuccols, 2013). From the above case, Fran meets the moderate level substance use disorder. This is because she met five demands of the criteria. On taking the painkillers, she found out that she liked the feeling of calm and relaxation after taking the medication. This resulted to her lying and kept demanding for more medication. She also found it difficult to not do away with the drugs and when she did she experienced symptoms such as anxiety and irritability. Although she believed that the painkillers helped her get through work, it was not the case since she started reporting late to work repeatedly therefore putting her job at risk. Her addiction to the painkillers started costing her relationship with the husband. He described her to be behaving differently, irritable and detached. She also showed signs of not being satisfied with the current dosage and increased the dosage.
Treatment of Painkiller Addiction
Painkiller addiction just like any other form of drug addiction has been shown to cause an individual, damages. According to Fran’s excerpt, it all started as a form of medication to help alleviate pain distress after car accident she got involved in, but it later came to grow to a level of addiction. One of the methods to help alleviate the problem is to discontinue using the drug (Newton 2015). After stopping from using the painkillers, she should be given some form medication such as clonidine which helps avert the withdrawal symptoms expected.
Another form of treatment would be the traditional method of detoxification (Newton, 2015). This method is advantageous since it is safe, and helps provide the patients to returning to healthy productive lives. This method, however, effective has some challenges as it is a forced system thus a lot of patients involved usually drop out. This is because the system is very intense, and the withdrawal symptoms do not make the situation any better. Sometimes even when the patients can get through the detoxification system successfully, the success rate is described as poor as most of these patients fall back to using the painkillers.
After withdrawing and detoxification, it would be ideal for her to attend a therapy program in any center to help with the recovery process. This is important as studies show that most people who get off from detoxication slip back to the system owing to psychological and social factors. One good example is to attend the Narcotics Anonymous (NA), a community based meeting for those recovering from drug addiction (Newton, 2015). Narcotics Anonymous involves a 12-step designed program to help in the process of combating addiction to narcotics. This system is the best because it is an abstinence program as opposed to the maintenance therapy where the recovering addicts are put on methadone to recover.
Prescription Drug Abuse Statistics
The Center for Disease Control (CDC) marked out that prescription drug abuse is an epidemic not only in the United States but also in Europe, South Asia, and southern Africa. The mark is increasing day by day with a lot of people engaging in painkiller abuse. Every day in the United States, youths aged between 12-17 abuse a pain reliver drug for their first time. In the United States alone, there are more than 15 million abusers of prescription of prescription drugs. This number is more than the combined report of abusers of cocaine, heroin, inhalants and hallucinogens. In 2006, 2.6 million abused prescription drugs for the first time in the United States (CLAAD, n.d). According to the 2007 survey, it was highlighted that 3.3% of 12 - 17-year olds had abused prescription drugs while 3.3 percent of 17-25-year olds had abused prescription drugs.
Statistics also highlight that abuse of prescription drugs result in the highest number of deaths. In 2010, it was registered 22, 400 drug deaths resulted from drug overdose with the most common drug being opioid. Depressants, antidepressants and opioids are the drugs responsible for the overdose deaths. In the United States, most of the deaths resulting from overdose used to take place in African American neighborhoods while now they take place in white rural communities (CLAAD, n.d). The same can still be seen in the hospitalization rate from overdose with the whites leading the figures. Out of the 1.4 million of admission in the emergency room, 598, 542 were linked to having overdosed on pharmaceuticals alone. Women also contribute the highest number of opioid users in the United States. The number of women having lost their lives to painkillers rose to 415 percent between 1999- 2010 compared to the ratio of men of 250 %.
Contributing Factors to the Trends and Demographics
To relive or reduce tension is one of the reasons for the abuse of prescription drugs. Most people take prescription drugs because of the feeling that it helps in reducing pain and tension. When these drugs are taken for a long period they induce addiction. Some anti-anxiety drugs for example benzoidiaphizines help induce pleasure in the user and can lead to addiction as a result of constant use. Some people abuse prescription drugs because they want to prevent withdrawal symptoms. After being on medication for too long, people may be faced with withdrawal symptoms once they stop taking the medication. To avert this feeling the continue abusing the drug. To be accepted by peers or other relevant groups may also force people to engage in drug abuse (Haerens & Zott, 2013).
References
CLAAD (n.d). Prescription drug abuse statistics . Retrieved from http://claad.org/rx-drug-abuse-stats/
Haerens, M. & Zott, M.L. (2013). Prescription Drug Abuse. New York: Greenhaven Press
Newton, D.E. (2015) Prescription Drug Abuse: A Reference Handbook. Santa Barbara, Ca. ABC- CLIO.
Nuckols, C.C. (2013). The diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) . Retrieved from http://dhss.delaware.gov/dsamh/files/si2013_dsm5foraddictionsmhandcriminaljustice.pdf
