Assess Addiction: Screening & Assessment for Appropriate Treatment - Research Paper

Introduction

Assessments are used to determine whether addiction is present and to determine the extent of the abuse. Understanding the nature and extent of addiction is key in diagnosis, having appropriate case management and successful treatment. During the screening, understanding will help the assessors to match the patient with appropriate services for treatment. To check whether co-occurring conditions exist which will be helpful with the treatment plan. Assessment is also key in receiving the correct treatment while determining what is the best diagnosis and treatment. The assessment questions are usually private and confidential. The assessment also involves physical examination to determine the physical symptoms of addiction to diagnose conditions which re-occur, so that they are treated together with the addiction. Co-occurring medical conditions may affect how addiction is treated. So assessment by the doctor is essential, and it should occur as early as possible in the treatment process. During the assessment, the doctors and the clinicians will use urine samples and questionnaires to make assessments. This will enable them to have their clinical judgment so that they can make a diagnosis. An integrated assessment helps come up with a structured measure, general functioning and getting information for the readiness to change. As the client goes through treatment, assessments will help in monitoring as the client moves through recovery.

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Assessment is also helpful in gathering key information and engaging the client in knowing whether they are ready for change. It also helps the doctors in understanding the key problem areas and their well-being. It involves several oral and written exercises.

Self-assessment can be the first step to determine if a person is addicted to alcohol or drugs like Joanne. She self-assessed herself, and in her opinion, she had a problem then she presented herself to the doctor (Sandberg, Richards, & Erford, 2013).).

The patient, in this case, should also be assessed for Co-occurring disorder. This is because the use of drugs and alcohol may lead to a rise in complication associated with mental disorders. The recovery trajectory can be largely affected if a person has untreated health or medical problems. This is because a person is tempted to relapse to the behaviors which are addictive. Diagnosing a co-occurring condition is important in a patient with alcohol addiction. In the case of Joanne, we see a co-occurring disorder. She is addicted to alcohol and gambling, making it hard to differentiate one from the other.

During the assessment of Joanne, one the most important factor which should be put into consideration is religion and spirituality. This plays an important role in embracing different coping strategies. Religion can act as an emotional outlet in managing stressors. Common activities in the religious set-up include visiting religious leaders or congregating at a religious setting. A challenge the assessors face in spirituality is gauging a person's nature of religiousness or spirituality.

Sources of Information

Information will be obtained trough questionnaires given to Joanne, where she can tick yes or no in answering indicators on whether she is addicted. The information will also be obtained by asking questions and recording the given answers. Screening can also help in determining whether there is need fo further, and thorough evaluation. Screening does not require any special training.

Background Information

The background information involves any of substance abuse including a history of substance abuse and the family patterns of such abuse. The background information includes checking on the family for any information on mental health problems. Such health problems include health status, any diagnosis, symptoms and medical adherence. The background assessment will also focus on determining the severity of the past abuse, symptoms distress and the role of substance abuse in maintaining, interfering or worsening the current mental conditions.

Joanna began gambling over ten years ago. She enjoyed it even though she never won as much. She started with $20 worth of lottery tickets, and she has never stopped. Six years ago she started playing lottery machines, and she became hooked, this led to her isolation from her friends. She began hiding so that people who know her may not find her.

Current Status

Addicted to alcohol and gambling and she is depressed. She has a co-occurring disorder where she is taking alcohol to avoid feeling the loss of her money in gambling. She uses alcohol to alleviate her depression after losing money when gambling. Also, she feels depressed because she does not feel loved and she feels judged by everyone.

Indicators of Use/Abuse/Dependency

Self- assessment can help in determining whether one had a dependency on a substance or drug. Using some questionnaires require a 'Yes' or 'No' answer and can help one in the evaluation of themselves in determining whether they have an addiction problem. Self- assessment can be conducted privately. Joanne is using the substance secretly; she is using her savings; she is in debt, withdrawal symptoms and continued use despite knowing the effect on her family. Other indicators for her abuse includes her inability to curb the alcohol or addictive behaviors she has. She feels the need to change, and even recognize the problem, but she is unable to change. Over time, she has learned to depend on alcohol to achieve the desired effect; like feeling good for her loss of money to gambling. She is experiencing psychological dependence on alcohol (Peele et.al, 2012). The frequency of consumption and the intention of drinking shows a pattern of abuse and dependency.

Attitude and Behavior

She feels judged and chooses to stay away from people. She prefers staying alone most of the time, and she is inapproachable even by her children. She has neglected her duties as a wife, and she does not feel enthusiastic about anything; even the house chores. Even though she recognizes the problem she has, she seems to have no control over her addictions.

Social Functioning

Her social functioning is impaired; she prefers to stay away from everyone to mostly avoid being judged. She prefers to avoid people because she is afraid of being judged and she does not want people to know that she has a problem.

Occupational Functioning

She is a stay home mom, but she no longer likes to do any chores. Most of what she is doing is not productive and she spends most of her time gambling or drinking alcohol.

Financial Factors

She is getting into debt because of her addiction, and she has lost control of her finances. She is in debt, and she has spent all her savings. She is unable to manage her finances well. Joanne is going to extents of trying to steal from her daughters'.

Familial Relationships

She is no longer intimate with her husband, and her children are confronting her because she is unwelcoming. She does not take her children to church anymore, and she avoids people.

When she is around her friends and family, she feels like no one believes in her; hence she would rather avoid them. She has actively stopped participating in family matters, including their sexual relationship and disinterest in house chores.

Legal History

Joanne is 45 years old, she has been married for 25 years, and she has three children.

Health History

Joanne is health history is clean. She does not have a major trigger around her. However, she appears to have had a psychological problem for almost ten years. She is depressed, anxious and has avoidance behavior.

Spiritual History

Joanne's Spiritual history will be important in her assessment because it will help in determining her coping strategies and how to reduce stressors. Joanne grew up in the Catholic church but has not gone to church for many years. She rarely attended church after getting married, and she has never taken her children to church. Owing to her lack of a strong spirituality, the spiritual aspect of coping and healing may be eliminated, and other forms like support groups should be considered.

Diagnostic Impression

Diagnosing disorders occurring alongside alcohol addiction are done like alcohol addiction diagnosis. In diagnosing the co-occurring disorder, observation is the most important tool at the disposal of a clinician. During an addiction assessment, symptoms associated with addiction include the following. They include symptoms of depression which include fatigue, loss of appetite, suicidal thoughts and a depressed mood. The other symptom to look for is Post-traumatic stress, manifested through behavioral avoidance, emotional numbing and dissociation. The other symptom is anxiety, where a person is restless, has a loss of energy and inability to concentrate. These symptoms are present in Joanne. She avoids talking to people, she feels judged, she is anxious, and she is showing signs of depression (Simmons, 2012).

A gambling problem is present when a person's most time is pre-occupied with gambling. Joanne has neglected her wifely and motherly duties and spends most of her time gambling. The signs of the problem include a person is mostly pre-occupied with gambling, they feel the need to use more money frequently, and there is loss of control over the behavior. Also people with gambling problem "chase losses," like in Joanne's situation. She has a gambling problem because she makes losses, but she continues to gamble. She has also used all her savings on gambling, amounting to $1500, and she continues to chase the losses. She resorts to drinking alcohol while trying to relive the stresses. Gambling can be regarded as a chronic recurring disorder. When the consequences of gambling start to pile up, they resort to taking alcohol to help them forget.

Treatment Recommendations

Individualized treatment planning requires a comprehensive assessment. The treatment process can start with the detoxification of the patient. Treatment interventions and treatment plans can be complex depending on what the medical practitioners discover at different levels. This leads to another fundamental principle; individuals have no correct intervention for COD. Appropriate plans must match individual plans according to several considerations.

Treatment will depend on the tools and questionnaires used in the assessment and screening process. The ethnicity and culture of Joanne may determine how she goes through the assessment and screening process. If Joanne is from a diverse ethnic group, she may see the process of asking questions about her substance abuse to be intrusive, foreign and threatening. Sometimes a person can see questions regarding personal habits as intrusive.

The Ideal Integrated Treatment Plan:

Joanne, our patient, can start with a detoxification plan once she has gotten to the treatment phase which is active. Each disorder requires that a specific trigger is identified. Identifying how gambling and alcohol abuse trigger each other is also an important part of the treatment plan. For gambling, reducing or limiting has been seen to be more effective. Joanne meets the criteria for pathological gambling; hence she needs also to be taught on money management tips and behavioral interventions to limit her gambling. Drugs such as serotonin reuptake inhibitors (SSRIs), such as fluvoxamine (Luvox), and opiate antagonists, such as naltrexone, have been seen to reduce the desire for gambling and alcohol intake.

Research has shown that many people who develop a gambling problem mostly have other psychiatric conditions. Most of the ti...