Principles of Psychopathology: Diagnosis and Treatment
Addiction in general, but opioid dependence has become a billion dollar business for the treatment industry. Heroin used to be the only widespread opioid used. The new opioid users are those who are given pain pills by their family and ER physicians. What happened to the old adages that if it hurts take an aspirin? Today’s unusual mix includes cultural differences of people who do not speak English and those who suffer from mental illness or personality disorders. No one wants to be in physical pain; however, the giver should investigate the family history of alcohol and drug abuse and adhere to a requirement of explaining to the user the dangers of this medication and the cause and explain the likelihood of addiction because of prolonged use.
John is a 30 year old White unmarried male addicted to opiates. He states he has a 15 year history of marijuana, alcohol, and IV heroin use. John has 3 brothers. He states his youngest brother is in prison for murder, and his two oldest brothers have no substance addiction. John states that both his parents are deceased and alludes to the connection of his mother’s death to his brother’s incarceration, but declines to go further into the story. He states that his father died of alcoholism. John has so far declined giving any information of mother’s substance or mental health issues. John displays two tear drops from the corner of his right eye. When questioned about this, because in jail terms the display of tear drops has meaning that this person murdered the number of tear drops, John states they are in memory of his parents. John states that a ‘crew’ of friends would make a weekly drive of 5 hours one way to a neighboring state to obtain heroin for personal use. When asked why he was seeking treatment at this time, he stated he was tired of travelling to get drugs. He states that he has been incarcerated for a short time and charged with DWI.Substance (opioid) dependence is defined by three or more of these symptoms in a 12 month period and in diagnosing John for opioid dependence he appears to satisfy all 6 criteria. 1.Tolerance is explained by the need for more drugs each time used 2.A. Withdrawal that include physiological and cognitive pain when the drug is stopped and the user searches for more drug to eliminate the pain B. Using the drug throughout the day continuous as to stay off withdrawal 3.Unsuccessful attempts at quitting or cutting down on drug quantity. 4.Spends large quantity of time either seeking the drug, using or recovering from withdrawal 5.Person’s daily is planned around the seeking, using, and recovering from the drug 6.Withdrawing from friends and family (American Psychiatric Association (APA), 2000 pp. 192,194,195,270). John presented with symptoms and signs of opioid dependence, however, as time passes and his dose of Methadone becomes regulated, his behavior has become more erratic, b) anger-ridden, c) fearful, d) bordering on the line of non-compliance, e) impulsive, f)continues to use illicit substances,) has been asked to leave a restaurant because of volatile and harassing behavior, h) loss of full time employment, i)showing signs of becoming frantic when routine is out of order, and j) demonstrates paranoia by stating that he is the only one being ‘persecuted’. If these symptoms were individual, John would most likely be exhibiting unacceptable behavior coupled with high anxiety; however, the combination of these behaviors constitutes the diagnosis of Borderline Personality Disorder (Seligman, 2005, pp. 369,370). When John presented for intake, his demeanor was calm, insightful, and appearing to have a genuine desire to stop using heroin. However, since being in Methadone Treatment where the doctor gradually increases the dosage from zero to a stabilized dose,...