Treatment Plan for Heroin Abuse Case Study

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Total Length: 2549 words ( 8 double-spaced pages)

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Demographic Information

Jodi is a 22-year-old Hispanic female. She is a single mother but does not live with her daughter who enrolled in the foster care system. She completed her general educational development (GED) tests, but her Certified Nursing Assistant Training Program is still pending. Her past medical history indicates that she gave birth prematurely but has no known allergies.

Assessment of Data

Jodi became pregnant and gave birth to a daughter after a raped ordeal. She patient has a five-year addiction to treatment. She administers the drug five to six times a day through the intravenous route. She enrolled in both the outpatient and inpatient detoxification programs but did not finish. She was treated with Suboxone for one month before she abandoned the pharmacological therapy and has a history of marijuana and alcohol abuse. Moreover, Jodi has depression that has led to a suicide attempt. Despite being diagnosed with post-traumatic stress disorder (PTSD), no treatment or remedies have been administered. She visited the emergency department in the past month for treatment of an abscess; it was unpacked and an antibiotic administered. However, she did not complete the dose and noticed some recent redness and swelling in the area.

Additional Data Needed by Counselor to Plan Treatment

Jodi is noncompliant to her pharmacotherapy treatment. She has failed to finish her detoxification sessions on two occasions. Moreover, she did not complete her antibiotics that were administered after abscess treatment. She has basic education and can understand medication instructions regarding the duration, dose, and frequency. Jodi has recently been arrested for prostitution; she should be advised on using condoms to protect herself from HIV/AIDS and other sexually transmitted diseases. A medical examination revealed that she was underweight and had irregular menses.

Standardized Screening Measures

Before the screening, it is essential to note down all the relevant historical information about a patient whether medical, hospitalizations, social or family. The goal of screening is to identify any drug-related problems. Testing of drug-related issues is mainly done by conducting interviews with the patient or asking them to fill in a questionnaire. The Alcohol Use Disorder Identification Test (AUDIT) can be used to identify any complications resulting from her alcohol use. It contains ten questions that are highly related, and there is a scoring guideline used to determine the severity of a case. The Beck Depression Inventory-II can be used to identify any changes in her mental health. It covers any short terms changes that include depression, anxiety, somatic signs, and social dysfunction of any kind. There is no specific tool for safety screening of suicidal thoughts and para-suicidal attempts and the questions a clinician asks only act as a guide to avoid underestimating the risk of Jodi injuring herself.

PTSD can only be appropriately screened by asking relevant questions regarding the history of a traumatic event in the life of Jodi. Additionally, symptoms that have persisted for longer than 30 days should be noted that have led to her decline in how she relates to people, and avoidance of questions regarding the trauma. The use of heroin can be screened using the use of the NIDA quick screen test and the NIDA modified assist. It asks questions that check for the use of illegal drugs and prescription drugs for nonmedical uses. A resultant score chart is used to identify the risk level of the patient. If the total points are more than 27, a patient can be considered as being at high risk, and the clinician should offer the relevant support for the condition.

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However, a score between 4 and 26 puts the patient at medium risk, and the doctor should consider referral based on the clinical judgment. Finally, a score of less than four is low risk, and the patient should be advised to abstain from drugs. She should also be subjected to bacterial cultures to determine the specific strain of bacteria that has affected her and whether it has become resistant to antibiotics or not.

Potential Relevance and Biases with Multicultural Populations

The instruments and screening methods used should have been tested and on women of specific culture and others from special populations before being adapted for use. The step helps to ascertain their effectiveness. Jodi needs advice regarding the screening and methods to ensure that she does not find the process to be threatening, scary or intrusive (Straussner, 2012). The screening should be approached in a way that establishes cultural relevance and winning the patient’s confidence so that she can open up. The questions asked should be replaced with an in-depth discussion with the patient to help in understanding the extent of drug abuse from her point of view. Screening staff should be trained efficiently about the ethnic groups that they will be serving. Additionally, they should be prepared for practical communication skills and ways of creating interpersonal relationships (Kaminer, 2013). This step will help in reducing the possibility of clinicians having preconceived ideas about a particular ethnic community about substance abuse.

Reason for Choosing Screening Instruments

The decision of choosing the particular screening methods and instruments is based on the following criteria:

· The tools have passed various quality control tests and have shown reliable results in the diagnosis of different conditions among women of diverse cultural backgrounds and special groups with minimal margins of error.

· These methods are reliable in producing results without making the patients feel victimized or uncomfortable. The questions asked are prepared by professionals to ensure that all the patients can answer without feeling shy.

· The instruments offer reproducibility in results, which makes them reliable.

Differential Diagnosis

· Addiction to the heroin- Jodi depends on heroin on a daily basis taking the drug up to six times daily via the intravenous route.

· Depression. Jodi experiences the feeling of guilt, helplessness, and irritability. She has even attempted to commit suicide once. Additionally, she has presented with weight loss.

· Post Traumatic Stress Disorder- Jodi has PTSD from a rape case that resulted in her being pregnant. She still recalls the events that occurred to her and feels shy to talk about the specific actions of the trauma.

· Staphylococcal bacterial infection- bacteria is the most prevalent cause of an abscess and cultures should be done to determine whether or not it is present.

· Pregnancy- Pregnancy test should be done to exclude it as a cause of irregular menses.

· Stress- it might be a possible cause that leads irregular menses.

· Polycystic ovarian syndrome- should be excluded because of the irregular menses.

· Hyperthyroidism- the levels of thyroid hormones should be measured to exclude the condition because Jodi mentioned having irregular menses and weight loss.

Co-Occurring Medical Or Psychological Conditions

Jodi has been engaging in prostitution in the past few months. Moreover, Jodi is also a subject of substance abuse, which may impair her judgment leading to her engaging in unprotected sex. Therefore, she should be asked to visit the nearest….....

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