Substance Abuse Counseling

Substance Abuse Counseling

The use of substance at an early age for non-medical purposes for purposes of gratification is common and widely spread. Readily available over – the – counter drugs, marijuana, and other drugs are cheaply found; this makes it commonly available to children (Lewis et al., 2014). The purpose of this paper is to understand Leigh’s case and note the best way to handle her legal dispute.

Overview of the Case Study

Leigh, a 16-year-old marijuana and alcohol user, was caught by police together with her friends following a complaint filed by neighbours. Because of Leigh’s state, concerned officials discussed the possibility of charging Leigh with possession. They tried to persuade Leigh to seek medical help. It bore no fruits.

She was assessed to and sent to involuntary medical detoxification for 28 days followed by an outpatient recovery program. For the next 30 days, she underwent assessment revealing her history of abuse during school and parties with friends she hangs out with.

KEYWORDS: pharmacodynamics, pharmacokinetics, etiology, diagnosis, pinocytosis, Delta (9)-Tetrahydrocannabinol

Procedures and Process for Assessment and Diagnosis

Treatment for substance abuse can be conducted per Adolescent Community Reinforcement Approach (A-CRA). A post treatment for 30 days should be followed up under Maudsley Addiction Profile and the Alcohol Smoking and Substance Involvement Screening Test. (ASSIST) the two will help:

• To find out the degree of abuse and severity
• To note a decrease and enable suggestions that Leigh will have made significant changes.

Cognitive Behavioural Therapy (CBT) and Cannabis Youth Treatment (CYT) can also be applied when Leigh is still under the outpatient program. These programs are appropriate because they focus on improving the mental health and behavior of the patient (Vinson, 2006).

Pharmacodynamics and Pharmacokinetics

Pharmacodynamics effects include subjective, cognitive and psychomotor performance. Urine, fluids from the mouth, sweat should be checked for drug traces. With pharmacokinetics, we should be able to spot delays in distribution to effector sites since we know that Leigh smokes (Hollman, 2018). Most of the pharmacokinetics and pharmacodynamics are known but some are still relatively new.

When marijuana is given to Leigh orally for systematic effect, the drug will need to reach to the epithelial lining of the stomach and be able to reach the lipid membrane barriers. Through pinocytosis any substance will be incorporated into a cell which will later be transferred to the cell interior (American Psychiatric Association, 2013). These barriers that have been highlighted can affect the drugs onset and also alter its peaking.

The main source of pharmatical effects caused by her intake is Delta (9)-Tetrahydrocannabinol (THC). The rate, at which alcohol is taken in, distributed, metabolised and makes its way out of the body makes up for the Blood Alcohol Concentration (BAC). Alcohol has hydrophilic and lipophilic properties and can get easy access to the body just like water and across other membranes into cells by simple passive diffusion. After alcohol has been taken in, it’s almost immediately absorbed in the blood, peaking in about 30- 60 minutes. When absorbed it will be distributed and Leigh achieves a higher percent of BAC because of her age. The drug will then be metabolized by the principal enzyme is alcohol dehydrogenase (Class 1 ADH).

Checking if Leigh administered alcohol in small doses within a short period of time is also important. If she did, this will make it difficult to notice the maximum BAC. The BACs reached after consumption depends on the amount of dose and interaction between the various processes.

DSM-5 Diagnosis

Leigh showcases all the symptoms of addiction.

1. Cravings: the need to consume alcohol or take a smoke to keep her at rest, relieve her stress.
2. Loss of control: every time Leigh drinks with her peers she feels the urge to drink some more. She knows that sometimes she loses control. She needs to avoid social gatherings and parties with her adolescent friends.
3. Continued use despite negative consequence: even though Leigh knows that it’s not beneficial for her to use the drugs. She still does it. This is the evidence needed to support the fact that this is no longer a habit to Leigh but now a dependency state.

From the above evaluation, Leigh needs medication detox since she is dependent on the drugs at this point.

Mental Health Issues

At this time, Leigh’s brain is still developing and her substance use, she has dietary issues. This can be explained through the fact that she spends most of her time drinking and smoking rather than prepare a proper meal for herself. Her marijuana use makes her brain gravitate towards unhealthy drug-using peers who encourage her to shoplift. She is also unable to make her own decisions since she still drinks in school instead of focusing on her studies.

Etiology

Leigh’s disengaged relationship with her father and the constant feeling that she has to choose between her parents is among the major reasons she began using drugs. Her poor hygiene and poor eating habits have caught up with her. Her look on the world as unfair also drove her to drugs.

Dual Diagnosis

Leigh has mood, personality, anxiety and eating disorders. Leigh’s should be able to come to the all family therapy, the parents should learn how to deal with Leigh and also attend individual counselling on the same. Pharmacological therapy can also be used together with making Leigh understand the need for treatment.

Treatment Options and Relapse Plan

Leigh’s should undergo behavioural counselling, given appropriate medication for withdrawal and also for co-occurring mental health issues such as depression and anxiety. Also she should be subjected to long term follow-up to prevent relapse. The long term plan should be followed closely by administrators and counsellors while giving Leigh the opportunity to air out here issues differently, not through drugs.

Risks and Protective Factors

The risks for Leigh are mostly on her family and her relationships if she continues to keep the same space of friends.

Ethical and Legal Issues

Bound by confidentiality, but still have a duty to warn the rest of the family if anything goes array. If there are also reports of emotional abuse from the parents to Leigh, there is still a duty to report the findings. There is a lot that could go right if the treatment is followed and Leigh sticks to solving the issues brought up under this case study. The approach for the case is different because Leigh is an underage who needs guidance to be able to overcome her dependency. This case study has provided the best ways to go about the addiction. Leigh needs a new circle of friends and a new way of communication to her parents who are not in agreement.