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A substance use disorder is a term that refers to a condition when a person takes one or several various substances and experiences clinical impairment, including the need to take more substances to function normally (Berger par. 1). The paper examines risk factors that lead to a substance use disorder, methods that may help to prevent its development, and steps of evaluation of a patient’s condition on the example of the case scenario about Marcella.
Marcella is a 15-year-old biracial (Caucasian and African-American) female who has been brought to the local community hospital because of an overdose of prescription pain pills, which, according to her own words, she has taken intentionally in order to kill herself. The girl possibly has a substance use disorder and is at risk of future problems with substances.
Considering Marcella’s family history, it can be concluded that she indeed has many risks for developing a substance use disorder. Marcella was raised primarily by her grandmother and her husband, who both drank alcohol throughout their adult lives and experimented with various drugs while were younger. Her grandmother’s husband also smokes marijuana every day and says that he needs it to cope with the pain from a back injury. Marcella’s mother, in its turn, used various substances, which started at the age of 14, when her father shot himself, and rapidly progressed. As Thatcher and Clark state in their article, a presence of a parent suffering from a substance use disorder greatly increases the risk for an adolescent to do the same (169). In Marcella’s case, not only her mother had problems with substances, but her grandparents as well. Even though the grandmother’s husband is not related to Marcella, she could have received an indirect message about the substance use from him because of his use of marijuana.
Antisocial behavior, which Marcella demonstrates (she is able to name only two friends and says that she does not like people), can also be associated with a substance use disorder (Thatcher and Clark 170). According to Dodgen and Shea, individuals with antisocial personality disorder, which the girl can have, also develop a substance use disorder in 83% of cases (104). In addition, Marcella’s grades have been steadily going down during the previous four years, and an academic failure can be considered as a risk factor as well (National Institute of Drug Abuse par. 2). Finally, the lack of parental supervision has its influence in this case (National Institute of Drag Abuse par. 5).
On the other hand, Marcella’s self-report regarding the substance use history does not reveal any problems with substances, except the recent incident with pain pills. She states that she drinks alcohol only on special occasions, has never been intoxicated and has never used non-prescribed drugs before. To evaluate Marcella’s condition and conclude if she does have problems with substances, a series of steps should be made. Firstly, blood and urine samples should be taken to make drug tests. If other substances, except painkillers, have been taken, those should be withdrawn. Secondly, there is the need to talk with Marcella’s grandparents to find out more about her condition. Thirdly, since the substance abuse among peers could have affected Marcella’s use of drugs (National Institute of Drag Abuse par. 5), some of Marcella’s friends should be contacted. If what Marcella has said in her self-report about the substance use history is true, then her problem is more psychological, and she needs the help of a psychologist.
Finally, to guard the development of a substance use disorder, the girl should be instructed to visit some of the support groups or prevention programs. Those can be easily found on the Internet. In the process of prevention, the role of parents and schools is also significant. They should educate adolescents about the risk factors and consequences of a substance use disorder. Schools can also implement anti-drug use policies.
Works Cited
Berger, Fred K. Substance use disorder 2014. Web.
Dodgen, Charles E. and W. Michael Shea. Substance Use Disorders: Assessment and Treatment, San Diego: Academic Press, 2000. Print.
National Institute of Drag Abuse. Preventing Drug Use among Children and Adolescents (In Brief): What are risk factors and protective factors? 2003. Web.
Thatcher, Dawn L. and Duncan B. Clark. “Adolescents at Risk for Substance Use Disorders.” Alcohol Research & Health 31.2 (2008): 168-176. Print.
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