Assignment Description: Case Information For Fran S. Arreste ✓ Solved

Assignment Description Case Information Fran S was arrested

Assignment Description Case Information Fran S. was arrested

Fran S. was arrested for prescription fraud when she tried to obtain prescription painkillers at a pharmacy with a fake prescription. You have been asked to assess her situation and make treatment recommendations to the court. Fran S. is a 32-year-old employee at a local bank. She was briefly hospitalized after a car accident 14 months ago and sustained injuries to her neck and back. Her doctor prescribed painkillers for these injuries.

He told her that she should only take the painkillers for a few months, but Fran found that she liked the feelings of calm and relaxation that the painkillers produced. Even though the pain from her neck and back went away, she kept telling her doctor that she was in pain so that he would continue prescribing the drugs. When her own doctor told her that he would no longer prescribe the painkillers for her, she found it difficult to go for more than a few days without the painkillers (she reported feeling anxious, irritable, and “not herself” when she stopped taking them) and found another doctor who would prescribe her painkillers. Fran told herself that the painkillers helped her get through her day, but she started missing deadlines at work and repeatedly coming in late, putting her job in jeopardy.

Her husband also reported a difference in her behavior, saying that she was detached, much more irritable and likely to start arguments over minor issues, which had not been a problem in the past. Fran started taking larger doses of the painkillers because she had stopped feeling their effects at the smaller doses. Her second doctor became suspicious of how frequently she needed prescriptions and refused to prescribe her any more drugs. Fran tried again to stop using the painkillers but found that she was experiencing problems, such as headaches, blurred vision, and anxiety, when she was not taking the painkillers. She could not find another doctor to prescribe her the painkillers, so Fran started submitting fake prescriptions to the pharmacy.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) lists the criteria for assessing whether a person has a substance use disorder, which it divides into three levels of severity: mild, moderate, or severe. Use your available resources to research the DSM-5 criteria for this disorder.

Provide a summary of the symptoms necessary to diagnose a substance use disorder according to the DSM-5. Identify the differences between the criteria for assessing mild, moderate, or severe substance use disorder according to the DSM-5 and the previous DSM-IV criteria for Substance Abuse and Substance dependence. What level of Substance Use Disorder (if any) would you diagnose Fran with and why? Which diagnostic criteria does she meet? Support your diagnosis with examples and research. Based on the case information presented, what recommendations would you make for treatment for Fran? Support your choices with evidence from the professional literature. What are current demographics and trends in the abuse of prescription medication? Explain. What are the contributing factors to these trends and demographics? Give at least 2 suggestions for how a doctor might work to prevent a patient from becoming addicted to prescription drugs. Compile your responses to the above information into your final Word document. The paper must be 1,500-2,500 words in length. All sources must be referenced using APA style.

Paper For Above Instructions

Fran S.’s case presents a compelling example for the assessment and management of substance use disorders as outlined in the DSM-5. Based on her history of prescription painkiller use, we can thoroughly evaluate her situation regarding diagnosis and treatment recommendations.

Understanding Substance Use Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorizes substance use disorders (SUD) into three levels—mild, moderate, and severe—based on the number of diagnostic criteria met. A substance use disorder is identified by a maladaptive pattern of substance use, leading to significant impairment or distress, manifested through various symptoms (American Psychiatric Association, 2013).

Diagnostic Criteria Summary

The DSM-5 outlines eleven criteria for diagnosing a substance use disorder:

  1. Taking the substance in larger amounts or for longer than intended.
  2. Desiring or unsuccessful attempts to cut down or control substance use.
  3. Spending a lot of time obtaining, using, or recovering from the substance.
  4. Cravings or strong desires to use the substance.
  5. Failure to fulfill major role obligations at work, school, or home.
  6. Continued use despite having social or interpersonal problems caused by the substance.
  7. Giving up or reducing important social, occupational, or recreational activities due to substance use.
  8. Using in situations where it is physically hazardous.
  9. Continuing to use despite knowing of ongoing physical or psychological problems likely caused by the substance.
  10. Tolerance, as defined by either a need for markedly increased amounts of the substance to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount.
  11. Withdrawal, as manifested by the characteristic withdrawal syndrome for the substance or taking the substance to relieve or avoid withdrawal symptoms.

A diagnosis of mild SUD is made when 2–3 criteria are met, moderate SUD for 4–5 criteria, and severe SUD for 6 or more criteria (American Psychiatric Association, 2013).

Comparison with DSM-IV

Previously, DSM-IV distinguished between substance abuse and substance dependence, with abuse involving a pattern of use leading to infrequent negative consequences and dependence leading to tolerance, withdrawal, and compulsive use. The DSM-5 combined these categories into a single disorder continuum based on severity (American Psychiatric Association, 2000, 2013). This has simplified diagnosis and emphasizes that different levels of severity exist rather than distinct diagnostic categories.

Diagnosis of Fran S.

In the case of Fran S., a thorough evaluation indicates that she meets the criteria for a severe substance use disorder. The observed symptoms align closely with the DSM-5 criteria:

  • Fran has persistently used painkillers despite the absence of pain, indicating her inability to cut down despite wanting to.
  • Her job performance has significantly declined due to her substance use, reflecting her failure to fulfill obligations.
  • She has experienced tolerance, as evidenced by her need for larger doses.
  • Withdrawal symptoms including anxiety and irritability were present when she attempted to stop using the substance.

Thus, it is clear that Fran’s substance use disorder is severe, meeting four to five of the eleven DSM-5 criteria.

Treatment Recommendations

Given the chronic nature of Fran’s substance use and the complexities associated with prescription opioid addiction, a comprehensive treatment plan is necessary. Evidence-based interventions include:

1. Cognitive-Behavioral Therapy (CBT)

CBT has been shown to be effective in addressing maladaptive thoughts and behaviors associated with substance use disorders. It can aid Fran in developing coping strategies to manage cravings and withdrawal symptoms (Beck, Wright, Newman, & Liese, 2011).

2. Medication-Assisted Treatment (MAT)

In conjunction with therapy, MAT may be beneficial. Medications such as buprenorphine or methadone can help alleviate withdrawal symptoms and reduce cravings (Centers for Disease Control and Prevention, 2021).

3. Support Groups

Participation in support groups like Narcotics Anonymous (NA) or SMART Recovery can provide Fran with community support and accountability in her recovery journey (Kelly & Yeterian, 2016).

Demographics and Trends in Prescription Medication Abuse

The abuse of prescription medications, particularly opioids, has reached epidemic levels in the United States. According to the National Institute on Drug Abuse (2022), approximately 18 million people reported misusing prescription opioids in 2020. Of concern is the increasing trend among young adults and women, which raises questions about the factors contributing to this rise.

Contributing Factors

Factors contributing to these trends include over-prescription of synthetic opioids and a cultural shift towards viewing these medications as safe due to their medical status. Additionally, access to healthcare and prior experiences with legitimate pain management can serve as precursors to misuse (Volkow et al., 2014).

Preventive Strategies

To prevent addiction to prescription medications, healthcare providers can implement the following strategies:

  • Prescribe the lowest effective dose for the shortest time necessary, with close monitoring for any signs of misuse.
  • Educate patients about the risks of addiction associated with opioid use and the importance of following prescribed guidelines.

Conclusion

In summary, Fran S. exhibits signs of a severe substance use disorder according to DSM-5 criteria. Implementing a treatment plan that incorporates cognitive-behavioral strategies, medication assistance, and support systems can foster her recovery. Additionally, understanding current trends in prescription medication abuse provides necessary context for prevention and intervention strategies in clinical practice.

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  • Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (2011). Cognitive therapy of substance abuse. Guilford Press.
  • Centers for Disease Control and Prevention. (2021). Understanding the epidemic. Retrieved from https://www.cdc.gov/drugoverdose/index.html
  • Kelly, J. F., & Yeterian, J. D. (2016). The role of mutual-help groups in the treatment of substance use disorders. The American Journal of Psychiatry, 173(5), 487-488.
  • Volkow, N. D., McLellan, A. T., & Friedmann, P. D. (2014). Opioid abuse in chronic pain: misconceptions and mitigation strategies. The Pain Physician, 17(3), 259-271.
  • National Institute on Drug Abuse. (2022). Prescription opioid overdose deaths. Retrieved from https://nida.nih.gov/publications/research-reports/prescription-opioids

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