Patient Relapse Case Study

Co-occurring disorders are common with most client cases that are presenting with a substance use disorder. Rosa is presenting with a history of several suicide attempts, alcohol use disorder, Post traumatic Stress Disorder (PTSD), and Borderline Personality Disorder (BPD). The client’s most severe symptoms are anger, fear, and shame. It is these symptoms that are complicating her life, causing distress, and self harming behaviors. Additionally, her treatment history is limited since she does not finish her therapy sessions.

I: CM guided client through ISP goals. CM inquired about client’s upcoming LAMP VASH appointments. CM discussed and encouraged client to get his driver’s license. CM praised client for being honest regarding drug use but also encourage sobriety. CM administered Beck Depression Inventory and review results.

PO returned to IOP group after being released from confinement. PO was on time and presented with a positive attitude. PO participated well in the group discussion and activities that included: checking-in; brainstorming the pros and cons of being in recovery, as well as the costs and benefits of continuing drug use. PO self-disclosed the use of heroin on 08-05-2015. PO used “The Payoff Matrix” handout to identify the Pros and Cons of his recent relapse, and shared feelings, thoughts, and behaviors that associated with relapse with peers openly and appropriately, also actively involved in the group discussion on how to stay motivated throughout the difficult times.

D: Client was on time for intake appointment. Together, discussed the assessment recommendation and barriers to successful treatment outcomes. Client reviewed and signed of all treatment admission paperwork, including treatment agreement, ROIs, THS treatment policies, THS alcohol drug Services patient rights, THS patient responsibilities, THS health and safety information, THS counselor disclosure information, patient grievance procedures, THS HIV/AIDS information, THS notice of privacy practices, referral to Quit smoking, and marijuana policy. Treatment plan was developed, which was focused on Dim 4, 5, and 6; focusing on developing readiness to change, identifying relapse potential, and building a strong family and social support system.

Abstract Observation in the case of Bryon has been occurring over the last 26 months. Observation has occurred in the context of Bryon and a licensed counselor. Bryon appears to be physically, emotionally, and mentally in less than favorable health, and reports poor decision making skills, low self-image, as well as prior and current addiction to drugs, alcohol, and sex. He has failed to thrive in many of the areas that most adults find success and reports that although he feels he battles with obsessive compulsive disorder, he also finds himself suffering from hoarding symptoms.

PO reported using substances to cope with boredom in the past. Isolation and does not have sober support putting her at risk for relapse. To be able to cope with unpleasant emotions in positive ways without restoring old behavior. willingness to stay clean and sober A) PO is to write a page paper and describe what happened the last time she relapsed. Include what you were doing, how you were feeling in the days leading up to relapse, and what you could have done differently to prevent the relapse.

I enjoyed reading your discussion post this week. I personally believe that patients that uses the methadone clinic is picking the lesser of two evils. According to Livingston, Adams, Jordan, MacMillan and Hering (2017) methadone clinics are considered part of an effective method during the treatment and rehabilitation process. From my past experiences working in the emergency room I feel as though methadone clinics do not address the real physiological issues that the patient is suffering from but instead causes another form of addiction. A study conducted by Karki, Shrestha, Huedo-Medina and Copenhaver (2016) concluded that injection drug users are at high risk of acquiring human immunodeficiency virus (HIV) infection through preventable

Tolerance develops when the abuser use more heroin to reach the same strength or outcome. Withdrawal, which involves regular users includes: drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps kicking movements and other symptoms. Sudden changes in behavior, Loss of interest, Small, restrained pupils, rapidly nodding off, hyper-alertness periodically, shortness of breath are some signs and symptoms of heroin. There are also some signs and symptoms that are: physical, psychological, and behavioral. Withdrawal symptoms may reach its highest between 48 and 72 hours after the last dose, but it decrease at an estimate of a week.

Limitations recognised throughout the SDM process were related to risk of further deterioration in the Consumer’s mental state. As the Consumer was slowly taken off his medications, in a safe clinical manner, his presentation deteriorated. The Consumer’s sleep pattern worsened due to the elevation in his mood, there was a noted increase in impulsivity and poor boundaries with others on the inpatient unit, leading to the Consumer becoming vulnerable. There was a prominent increase in erratic and aggressive towards others, leading to the assault of a staff member on the inpatient unit and subsequently required the use of restrictive interventions. The decline in mental state resulted in the Consumer’s father, case manager and treating team coming together for a family meeting with the Consumer present in which the previous medications the Consumer had been previously prescribed were recommenced in an attempt to re-stabilise his presentation, unfortunately this was a substituted decision made by the consumer’s father and treating tream.

Triggers, warning signs, and crisis planning are the components of the process, and require interdisciplinary work from the patient, nurse, doctor, counselor and other support staff. As with every human being, stress is a normal part of life. How we cope with those stressors is the difference between mental illness and mental wellness. With patients with substance-abuse issues, their coping mechanism is their substance of choice. So it is important to identify those stressors early on, identify early warning signs, look for inevitable situations where the patient feels like everything is falling apart, and most of all, prevent them from using.

Lewis stated that she believed the meeting was to evaluate for medications, as she was not on any medications at the time of the interview. She reported having high anxiety and rumination throughout her life. She stated that she was constantly worried and could not stop thinking about various scenarios. One scenario she discussed was the possibility of her ex boyfriend finding her upon release. She believed that her anxiety might have stemmed from her excessive rumination.

Discrimination against recovering addicts is occurring because of the use of methadone treatment. Some people believe that methadone treatment is unnecessary and that addicts should have to get over their addiction themselves rather than use other drugs to help. People can get addicted to methadone even though it does not produce an eutrophic high and some people say that withdrawing from methadone is worse than withdrawals from heroin. Methadone is a very dangerous drug and the doses have to be monitored carefully to prevent overdose and also to prevent withdrawal symptoms. Many people undergoing methadone treatment turn to crime to get what they want and need in life.

At this meeting they are discussing Hazel’s condition and reviewing her plan of care. Additionally, Hazel’s mother is expressing her concerns about her daughters behavior and she feels Hazel is “depressed.” Dr. Maria reviews various medical options to care for Hazel’s feelings of being depressed. She also suggests Hazel attends a local support group of other young people who are living with or surviving cancer.

Paula is a 43-year-old HIV-positive Latina lady initially from Colombia. Aside from confronting the disgrace of her HIV status and a bipolar issue, she is a divorced person who loses custody of her child’s (Plummer, Makris, Brocksen, 2014). She is accordingly inclined to psychological and emotional distress (Plummer et al., 2014). The Physician who is treating Paula with her may physical ailment ended up baffled with her because she utilizing all-encompassing medication instead endorsed prescription (Plummer et al., 2014).

She later realized that alcohol and drugs (heroin) were causing her to