Brian is married with two teenage children. He set up his own company, a packaging business 10 years ago, and has worked hard to make it viable. During this time his use of alcohol has increased. He currently uses alcohol on a daily basis and often consumes a 1.5L of bottle of spirits a day. He hides this from his wife, but she has recently wanted to talk about this, and is angry and frustrated with him. A recent back injury prompted him to go to his GP, who prescribed a codeine based analgesic.
The cause of Brian’s heavy drinking falls into both the psychological and social components of the bio/psycho/social model. Although there is no evidence of a biological link in the case study, it is possible that there might be a family history of heavy drinkers in Brian’s extended families.
I believe the psychological factors contributing to Brian’s heavy drinking are due to. • his shyness and social phobias, which leaves him with much anxiety attacks. • There’s also the stress of running a business and trying to keep it above water and the possible financial strains with the business and his own personal debts. • And also the pressures at home with his teenage children, and his wife
I believe the social elements are linked to
• Brian and his sports mad friends, who constantly gather to drink and cheer any game that is playing, • The weekly happy hour sessions with his work colleagues, and the business conferences or promotional events, where alcohol is always readily available. • Plus Family get-togethers and other social events are always a cause for celebrations.
The physical cause of Brian taking painkillers for his back injury is due to the unsafe heavy lifting at work.
For the Screening Assessment, I would suggest both the Leeds Dependence Questionaire and the Alcohol Use Disorders indentification Test, to detect whether Brian’s alcohol consumption has become hazardous or harmful to his health. AUDIT is a 10-item screening questionnaire with 3 questions on the amount and frequency of drinking, 3 questions on alcohol dependence, and 4 on problems caused by alcohol. It’s an effective way to identify opinions, causes and possible solutions to problems. Audit is efficient and easy to use, plus it only takes 2 minutes.
I would also recommend the “The Severity of Dependence Scale for Opiates” which would help to tell how dependent Brian is on the painkillers.
In regards to Brian’s Results of Assessment, the AUDIT shows that Brian scored a total of 24. “13 or more is interpreted as Problematic or Dependent Drinking”, so therefore Brian is placed at the Dependant level. The LDQ interprets Brian’s score also at 24, again placing him in the high dependence level (because its between score of 21-30). The SDS for Opiates score of 4 or more suggests dependency. Brian scored 3, which puts him on the harmful use bordering dependency on the continuum of use. So you can see, Brian’s results from the different tests are consistent with each other….that overall Brian is a dependent user. ASSESSMENT OF ISSUES
In terms of Physical issues. Brian is maintained by physical addiction given the amount of alcohol consumed over 10 years and also because he has an extremely high tolerance for alcohol. Brian experiences withdrawal symptoms such as shakes, fever, nausea, and needs to have a morning drink to maintain performance at work, and to function properly throughout the day. The longterm effects can have a devastating result on Brian’s body. His liver may become damaged through cirrihosis, which may lead to liver failure, liver cancer and also death. Mixing alcohol with his painkillers can further cause Brian to experience vomiting; drowsiness; fainting; loss of coordination; and can put Brian at risk for internal bleeding, heart problems, and difficulties in breathing. Alcohol also can decrease the effectiveness of a medication or make it totally ineffective.
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