Child molestation is a significant matter of concern, especially in the case of involvement of daycare centers. Sometimes, similar instances become the ground of a nationwide hysteria. Commonwealth vs. Amirault is an appropriate example of the abovementioned statement. The case came to the attention of investigators when a five-year-old boy, one of those brought to Fells Acres Day Care Center, told his parents that the owners son touched the boys private parts. According to the handymans story, he was helping the boy to change his clothes because he wet himself while sleeping in the daytime. The parents decided to report to Malden authorities when they noticed that the child displayed signs of unusual behavior. Therefore, police officers urged other parents who gave their children to the same center to study kids behavior and ask them about any strange developments, thus collecting reports of abuse in the daycare facility such as rape, taking naked photographs, and drinking urine (Crosson-Tower, 2015).
The investigative process was lengthy and strenuous. In addition to the time-consuming collection of parents reports, it included fifteen court hearings, as well as appeals and re-trials. They began in the 1980s, while the last court was held in 2004 (Crosson-Tower, 2015). During this time, numerous decisions were made. For instance, according to the initial court ruling, all three defendants Violet Amirault, Gerald Amirault, and Cheryl Amirault were sentenced to 8 to 40 years in prison. Violet Amirault, the owner of the daycare center, was accused of abusing eighteen children and condemned to twenty years in prison. Her daughter, Cheryl, was found guilty of ten instances of child abuse and sentenced to eight-year confinement. Finally, Violets son, Gerald, was accused of abusing nineteen children and adjudged to forty-year custody (Crosson-Tower, 2015). Nevertheless, all of them were found innocent and released later: Violet and Cheryl in 1995 and Gerald in 2004 (Crosson-Tower, 2015). As for the daycare center, it was closed (Commonwealth vs. Amirault, n.d.).
The solution is often criticized because it is based on testimonies of children aged from three to six years. Furthermore, they were interviewed in the courtroom where the defendants were present as well (Crosson-Tower, 2015). In this way, the sentence is questioned, as well as the comprehensiveness of interrogations, especially due to the subsequent release of the defendants. Still, it had a significant psychological impact on everyone involved in the case. As mentioned above, panic swept the community because parents grew hyper-vigilant and were afraid to take their children to daycare centers. As for children, they felt common consequences of sexual abuse, including shame, allegiance to an offender, anxiety, and embarrassment (Levinson, 2002). Moreover, they experienced severe stress caused by both abuse and continual interrogations (Michie, 2013). Finally, as for the defendants, this case, most likely, caused embarrassment and mental discomfort due to excess publicity and closing the daycare facility.
In conclusion, it is essential to mention that there are several takeaways related to this case. First and foremost, it pointed to the criticality of physical evidence. The case taught that children should be interrogated in the courtroom only if no physical evidence is available. Still, before interviewing them in one room with a perpetrator, vast work should be done before, including consultations with social workers and psychologists. In addition, it is critical to bear in mind that interrogations should be conducted in a game form to obtain accurate information and diminish the risks of psychological trauma, which was ignored in the case under consideration (ODonohue & Levensky, 2004).
References
Commonwealth vs. Amirault. (n.d.). Web.
Crosson-Tower, C. (2015). Confronting child and adolescent sexual abuse. Thousand Oaks, CA: SAGE Publications.
Levinson, D. (2002). Encyclopedia of crime and punishment. Thousand Oaks, CA: SAGE Publications.
Michie, J. (2013). Readers guide to social sciences. New York, NY: Routledge.
ODonohue, W. T., & Levensky, E. R. (2004). Handbook of forensic psychology: Resource for mental health and legal professionals. San Diego, CA: Elsevier.
Health care fraud and abuse are punishable by US law. Providers are fined, can be excluded from Medicare, and staff will face civil or criminal penalties (Harrington, 2019). There are Stark Law, the False Claim Act, and the Anti-Kickback Statute. The Centers for Program Integrity monitors and enforces these laws and implements legal and regulatory tools. Legal prevention methods are effective because the presence of criminal liability for fraud or abuse forces employees to approach work with dignity (Harrington, 2019). The Health Insurance Portability and Accountability Act (HIPAA) allows for regulating both legal and ethical violations. HIPAA establishes whether an action is abusive or rational, and fines are imposed depending on that (Harrington, 2019). The severe consequence for the provider is exclusion from Medicare or Medicaid. It limits an organizations allowable budget and makes it challenging to follow up with medical care. It controls costs and obligates the provider to manage staff actions.
Ethical anti-fraud and abuse practices include monitoring medication and treatment prescribing, payments and compliance, and patient and staff card generation. Recovery audit contractors allow practices and services to determine compliance with their price and avoid financial fraud by the organization (Terra, 2009). In addition, in this way, it is possible to achieve complete consistency between appointments and payments. Pay-for-performance is an effective tool to counteract fraud because this system limits how, to whom, and how many procedures are performed (Catalano, 2009). Among ethical practices, Harrington also points to the need for cooperation in risk areas where there is a fine line between the norm and abuse for example, intensive care (Harrington, 2019). Ethical practices will be effective if they are closely tied to the finances and internal policies of the provider.
Fraud and abuse cause significant financial losses to the organization: for example, exclusion from Medicare or Medicaid results in the loss of payers and patients. Criminal and civil penalties for regulatory violations result in fines of as high as $4 million (Harrington, 2019). As a result, providers do not have funds for the organizations other needs. Implementing service delivery standards and checking for pricing and ethical policies will prevent fraud and abuse. Reporting (financial, logistical, and legal) will establish the existence of systemic violations. Auditing and monitoring will establish whether personnel are responsible for their actions and whether all essential services are included in the reporting.
Harrington, M. K. (2019). Healthcare fraud and abuse. In Health Care Finance and the Mechanics of Insurance and Reimbursement (2nd ed.) (pp. 189-202). Jones & Bartlett Learning.
OBriens research on adapting treatment to the patient problem is purely descriptive. Descriptive research tends to describe the situation by adding knowledge to what is already known about the subject. Also, descriptive research uses methodologies that add up to the already known elements in a positive perspective. Hence, the recommendations and findings of the research aim at adding knowledge to the research subject.
OBriens research is descriptive based on the medical subjects of the relationship between treatment and the patients problem. The research subject is already in existence and thus it needs a description of information that would add value to it to enhance its effectiveness. Besides, by looking into the subject, viz. adapting treatment to the patient problem, it is descriptive in the sense that the reader expects the findings to be substantive for knowledge addition purposes on the topic. In the case of descriptive research, the research findings and recommendations are expected to be congruent with the researchers hypotheses coupled with proving and adding knowledge to the question.
OBrien (2011) used experiments as the key method for the research. Experiments produce substantive results that bear little errors in most cases as opposed to other research methods that demand the use of statistical methods to reduce the effects of random errors found in the obtained data. Also, it is easier to observe the recovery progress of a patient after going through this form of treatment than collecting data through interviews as the former saves time and resources.
On the research findings, the researcher found out that patients who receive this form of treatment, viz. a combination of medical treatment and patient problem, take a shorter period to recover fully as compared to patients receiving one form of medication. For instance, the subject of the research is the patient receiving a combination of treatments of depression and drinking and s/he takes a shorter period to recover than those who take either of the treatment in a given period.
The findings are valid and essential for the research topic, and thus necessary for this form of descriptive research. Besides, the findings are found to be congruent with the authors argument, and hence adding weight to the research question. However, the findings are not exhaustive to the research question as it relies on the combination of two forms of medication at a go, thus leaving room for further research on the same topic.
The researchers recommendation is in line with his initial hypotheses, which depicts that a combination of two forms of medication is more effective than a single treatment. Being descriptive research, the main aim of the researcher was to prove the argument through medical experiments, which produced positive results to the argument. Hence, the recommendation depicts the usage of adapting treatment to patients.
According to the researchers findings, this form of treatment depicts that a patient suffering from two habitual problems can be treated simultaneously as is the case of a patient suffering from both alcoholism and depression. Therefore, this form of approach is the recommended form of treatment for patients suffering from problems that could allow for this approach to the treatment procedure.
An Opioid Deficit in Borderline Personality Disorder
According to the authors of this article, medical researchers argue that substance abuse is the leading cause of unnatural borderline personality disorder in contemporary society. Drugs have adverse effects on the personality ethics of a person whereby an individual loses behavioral control to unnatural influences due to the use and abuse of drugs. Continual use of drugs leads to addiction, whereby a person loses personal character and personality and instead becomes dependent on acquired traits like taking drugs. The researchers explored this topic by a descriptive argument, whose findings and recommendations add weight to the question. Also, the researchers used other previous research findings and added weight to them using up-to-date findings. This research is relevant to the topic of substance abuse as it adds knowledge to the problem that has posed a great risk to contemporary society.
New and Stanley (2010) used a relevant research topic, viz. An Opioid Deficit in Borderline Personality Disorder: Self-Cutting, Substance Abuse, and Social Dysfunction. The above research question is very descriptive to the reader, which eases the aim of the researchers to prove its validity as it touches on a common societal problem. Through its descriptive form, the researcher is only supposed to prove the researchers argument by using experiments and other previous research findings on the same subject.
On the research methods, the researchers used experiments and medical data collection as the key methods for the research. Both methods are effective in producing results that would support the research question. Experiments are done medically by using real patients that suffer from a borderline personality disorder and they are subjected to the process of inducing neutral and sustained emotional mental states. Subjects behave differently to each state and results are recorded. A hypothetical statistic implies that borderline personality disorder has a prevalence rate of 5.9 percent in the general population, and thus researchers were interested in applying that hypothesis in the research.
The research findings are congruent with other previous research findings. From the experiment, it was found that patients who suffer from borderline personality disorder respond to the psychotherapy treatment in both circumscribed and transient manner as established earlier by other previous researchers. Besides, according to the medical statistical reports, this problem has resulted in high morbidity and mortality rates in society and the findings show that patients are neglected due to a lack of proper forms of treatment for the problem.
The researchers recommendation is in line with their initial hypothesis, which depicts that there is an opioid deficit to borderline personality disorder. Being descriptive research, the main aim of the researchers was to prove the argument through medical experiments, which produced positive results to the argument. Hence, the recommendation depicts the usage of psychotherapy treatment to the patients would improve the current situation where those patients are neglected due to the lack of an approved treatment for the problem.
According to the researchers findings, this form of treatment depicts that a patient suffering from borderline personality disorder should undergo psychotherapy treatment. However, patients respond positively to the treatment, which is the main goal of the researchers. They recommend the medical personnel to approve this form of treatment, as it would propel the medical field to greater heights as they wait for the discovery of other medications for the problem.
Adolescents, Alcohol, and Substance Abuse: Reaching Teens through Brief Interventions
Many adolescents see alcohol as a substance for enhancing happiness, which explains why it should be present in any well-organized party. Adolescents form part of the most influential groups in the human race and their greatest desire is to enjoy life to the fullest with little or no effort applied to the creation of joy, as is the case in the real life. Researchers have found alcohol and substance abuse to have very close relations as either can easily lead to the other. The author of this article sees the idea of keeping alcohol and substances away from vulnerable persons as the primary control of the problem, and hence his argument leads to the development of the research question.
Veenhuis (2002) used a relevant research question that seeks relevant answers to the societal problem of alcohol and substance abuse by adolescents. Looking into the research topic, Adolescents, Alcohol, and Substance Abuse: Reaching Teens through Brief Interventions, the research is descriptive and seeks solutions to the described problem. The topic adds value to the research question as to what needs to be done to contain the problem by proposing a brief intervention mechanism.
On the research methods, the researcher used information from the proceedings of a conference on substance abuse and alcoholism as the information necessary for value addition. This aspect implies that the researcher probably found knowledge gaps in the known facts about the problem according to the conference presentations. The researcher did not look for self-researched evidence, but rather he relied on the evidence of other previously done researches.
According to research ethics, a researcher is supposed to work on adding information to something less known to bring a solution to a problem or bring into existence a novel idea. In either way, the researcher is supposed to develop unique evidence, as other evidence would lead to known findings and recommendations. Hence, the researcher failed in this part by relying heavily on other researchers evidence in the development of a congruent recommendation.
The research findings are in line with other previous research findings. From the presentations, it was found that adolescents could be saved from substance and alcohol abuse via a brief intervention mechanism. According to psychiatrists and other medical practitioners, a childs behavior is shaped by both confrontation and brief intervention. The latter is used for warning or creating awareness about adverse effects that a certain act would bring forth to the child after committing that act. Confrontation is used for punishing the child after an offense or committing an act that is considered as wrongdoing.
The researcher recommends the brief intervention mechanism as the most effective way of containing the problem when applied to adolescents. However, it needs to be applied early enough when an adolescent is yet to crave harmful substances and alcohol. The researcher argues that confrontation is harmful to adolescents, as their reaction would render them into continual substance and alcohol abuse rather than stopping them; hence, the researchers argument is valid and necessary for further research by other researchers. Previous researches show that the brief intervention mechanism embodies love and gives a sense of self-worth to the recipient. In this case, adolescents will feel loved and appreciated and probably understand the dangers of alcohol and substance abuse.
Medication Treatment of Different Types of Alcoholism
According to Johnson (2010), alcoholism is a medical disorder in which a patient is addicted to alcohol after a prolonged period of overconsumption of the same. There are different types of alcoholism disorders whose types depend on the effects of alcoholism. In most cases, medical practitioners are capable of curing health defects that result from alcohol abuse, but the patient is responsible for the recovery period. This assertion implies that a patient has to control the attitudes that would enhance quick recovery from the problem. However, the most common types of alcoholism include chronic, late-life, and college alcoholism (Johnson, 2010).
Johnson used a relevant research question that seeks relevant answers to the problem of alcoholism to both the patients and the medics. Looking into the research topic, Medication Treatment of Different Types of Alcoholism, the research is descriptive and it seeks solutions to the described problem. The topic adds value to the research question as to what type of medication needs to be applied for containing the problem concerning the type of alcoholism. The research topic is valid about the nature of the argument in the question, more so as it leads to easy development of answers to the question.
The researcher used medical experiments and pharmaceutical evidence in the medical literature as the source of information necessary for finding results to the research question. There are three forms of medical treatments for an alcoholic patient, which include psychotherapy, a placebo pill, and brief intervention (Johnson, 2010). Psychotherapy is often done in the form of a psychosocial intervention mechanism for an alcoholic. The researcher experimented on the effectiveness of each form of treatment once done to an alcoholic patient.
The research findings are congruent with other previous research findings, but there are some elements of new results. From the experiment, it was found that brief intervention is essential for college alcoholism in the case of young adults. The psychosocial intervention was found not to be effective for an alcoholic dependent patient. A combination of behavioral compliance and psychotherapy was found as an effective intervention for chronic alcoholism after the failure of other forms of medication. However, placebo pills are effective for the treatment of all forms of alcoholism.
The researcher made recommendations that are congruent with each finding. He recommended the application of brief intervention to college alcoholism as the victims are young alcoholics and the method is necessary for creating awareness of the harmfulness of the behavior if it persists. Secondly, he recommended psychosocial therapy treatment to be combined with another form of treatment, as when used alone would leave a loophole for the resumption of the behavior by the patient.
Thirdly, placebo pills are effective for treating all forms of alcoholism, but they are harmful if used for a long time, and hence the researcher recommended their usage together with other forms of treatment. Looking into the recommendations, they are seen to be descriptive of the most effective forms of treatments for different types of alcoholism. Hence, the research was well done and in a recap, Johnson emphasized that alcoholism is a sickness, and patients of the same should not be left on their own. More research on the topic of alcoholism is imperative as more people are falling to alcoholism every other day with the youths being the worst hit demographic group.
Reference List
Johnson, B. (2010). Medication Treatment of Different Types of Alcoholism. American Journal of Psychiatry, 167(6), 630-39.
New, A., & Stanley, B. (2010). An Opioid Deficit in Borderline Personality Disorder: Self-Cutting, Substance Abuse, and Social Dysfunction. American Journal of Psychiatry, 167(8), 670-671.
OBrien, C. (2011). Adapting Treatment to Patient Problems. American Journal of Psychiatry, 168(7), 670-71.
Veenhuis, P. (2002). Adolescents, Alcohol, and Substance Abuse: Reaching Teens through Brief Interventions. American Journal of Psychiatry, 159(11), 1958-59.
Roy (2009) argues that addiction is a process that involves physiological changes in a person. The author (Roy 2009) considers addiction to be a social, cultural, genetic, and an experimental process. Addiction is a situation that gives a person temporary pleasure, especially when the victim is in discomfort. However, it is important to note that it always has a negative impact in the long term.
Addicts are individuals who depend on constant substance use (Roy, 2009). It is true that some sort of drugs can cause addiction if abused or used without a doctors prescription. Nonetheless, addiction is not limited to only drugs use as it also involves habits which can be addictive. Such habits as surfing in the internet, taking chocolates, drinking tea, gaming can also be very addictive. Being highly depended on something and being unable to live without it is, therefore, a sign that one is addicted.
Humans always seek for pleasure hence this is the bait for which people fall. Seeking for pleasure, addicts show an extraordinary desire and dependence on a substance. Addicts present a great desire to repeat a particular pattern of activity.
Roy (2009) describes addicts as individuals who are obsessed and depressed, hence using their obsession to counter their depression. Addiction can be controlled and stopped, but the right approach should be adopted. Through counseling and rehabilitation programs, many addicts have been able to get back to their normal life.
Stimulants, such as cocaine, are drugs that accelerate the heart rate increasing the blood pressure (Auburn Hills, 2012). Narcotic analgesics are drugs that relieve the patients or the users from pain, hence changing their mood patterns (Auburn Hills, 2012). Such drugs include Codeine, Heroin, Demerol, Darvon, Morphine, etc. (Auburn Hills, 2012).
Hallucinogens, on the other hand, are drugs that cause the user to see things differently than they really appear (Auburn Hills, 2012). They include drugs such as Psilocybin and Peyote (Auburn Hills, 2012). Lastly, the cannabis is another name for marijuana. The main component of the cannabis that makes people addicts is the delta-9 tetrehydrocannabinol, THC (Auburn Hills, 2012).
Addiction to the cannabis is the most popular addiction in the world today, especially among teenagers and generally young people. Cannabis addicts find it difficult to give up taking the substance as those who try experience such symptoms as insomnia, loss of appetite, depression, irritability, anger and many others (Leshner, 2001).
Research conducted by Leshner (2001) showed that in every ten people who used cannabis, one became an addict. Trying the drug several times increases the chances of addiction while daily users are at the greatest risk of developing dependency.
Cocaine, the famous white powder, is a very powerful and addictive drug that has a direct impact on the brain (Leshner, 2001). The drug is a very high stimulant that takes effect in less than ten seconds when smoked. Its pleasurable effects have made the drug popular among many young people as well as the older generation. Cocaine makes the user feel good and become talkative. Once an individual uses cocaine, it is very difficult to forecast if he or she will continue depending on the drug. This is due to its very high addictive nature.
Prescription of the drugs which may cause addiction may widely be used for non-medical purposes. Using drugs that have medicinal value for any other purpose apart from the medical use is therefore a drug abuse. There are classes of widely abused drugs which are the Opioids, CNS depressants, and the stimulants (Leshner, 2001).
Opioids are normally prescribed to treat pain due to their highly effective analgesic properties (Leshner, 2001). For instance, Morphine is widely used in surgery to mitigate severe pain before and after an operation. Taking such drugs causes rigorous depression, and this can lead to drastic occurrences such as death. However, prescribed doses are effective in managing pain.
Another category of drugs that can be widely abused is the CNS depressants. These drugs are medically used to slow down brain functions in order to treat anxiety and insomnia. For example, mephobarbital and pentobarbital are prescribed to manage anxiety, tension, and insomnia in patients (Leshner, 2001).
Diazepam and Chlordiazepoxide are prescribed to treat shock and panic attacks, acute stress reactions and anxiety (Leshner, 2001). However, continued use of these drugs may cause tolerance hence the body will require more doses to achieve the same effect. This may lead to physical dependence that may lead to withdrawal if the amount used is reduced.
The last prescribed category of drugs which can cause addiction is the stimulants. These drugs are used to enhance brain activities unlike the depressants that slow down the brain functions. This category of drugs causes the user to be alert and attentive by increasing the blood pressure (Leshner, 2001). Such drugs are prescribed to treat asthma and other respiratory conditions. Other conditions that can be treated with stimulants include obesity and neurological disorders (Leshner, 2001).
The Comprehensive Addiction Resources Emergency (CARE) and Excellence in Mental Health and Addiction Treatment Expansion (Excellence) Acts are public health policy responses to the United States substance abuse crisis. The two proposed policies seek to expand access to behavioral health services and treatment by allocating more resources to developing a robust treatment infrastructure than what is currently available. Additionally, the proposals intend to increase medication-assisted therapies and support wraparound care. According to Salmond and Allread (2019), a practical approach for addressing the opioid menace will need to combine prevention programs with greater accessibility to treatment interventions. The CARE and Excellence Acts propose an array of provisions that will expand the openness, convenience, and receptiveness of healthcare systems to people with substance abuse disorders.
The CARE Act
The United States is undergoing a nationwide public health crisis of substance abuse. Salmond and Allread (2019) contend that nearly 200 Americans die daily from drug-related complications. The problem has been aggravated by the absence of ambitious policies that expand access and promote substance abuse treatment. The CARE Act proposes developing a vibrant treatment infrastructure that brings together state, territorial, and tribal governments. Additionally, the policy suggests the funding of novel treatment models championed by local governments and nonprofit actors. Moreover, the proposal advocates expanding the existing health professionals training programs and expanding healthcare providers ( Cummings and Warren, 2019). Furthermore, the CARE Act broadens the accessibility to overdose reversal drugs and medication-assisted therapies by eradicating barriers that impede the delivery of standard treatment protocols. If implemented, the CARE Act would immensely expand accessibility to treatment options available for substance abuse disorders.
Excellence in Mental Health and Addiction Treatment Expansion Act
The Excellence in Mental Health and Addiction Treatment Expansion (Excellence) Act intends to enhance the full exploitation of Certified Community Behavioral Health Clinics (CCBHCs) in filling the gaps of unmet needs in addiction and mental healthcare. If adopted, the act will dramatically expand access to comprehensive community-based treatment programs. The CCBHCs have played critical roles in extending evidence-based addiction and mental healthcare to people who previously could not access such care. Preliminary results in CCBHCs pilot states show that the approach redefines specialty behavioral healthcare delivery in several ways. For instance, the technique eliminates barriers and expands patient-centered care penetration beyond hospitals (Canady, 2018). Upon implementation, the policy will enhance substance and mental healthcare accessibility to people in need regardless of their financial statuses. The Excellence Act will advance medication-assisted treatment and improve the outreach of care providers.
Public and Private Stakeholders Pushing for Policy Change
The CARE and Excellent Acts combine public and private stakeholders forces to confront the substance abuse crisis. The public stakeholders include the state governments, Congressional committees, and professional organizations. The House Committee on Oversight and Reform, the National Council for Behavioral Health, and the U.S Department of Health and Human Services are the leading stakeholders championing policy changes to promote behavioral health services. Private consultants on the opioid crisis are the most prominent non-public stakeholders engaged in fixing the proposals loose ends and full rollout. The most robust organizations promoting policies change include the Centerstone and A New PATH (Parents Addiction Treatment & Healing). Therefore, an integrated approach that combines private and public stakeholders will help develop practical strategic proposals that will increase access to behavioral health services in the U.S.
Conclusively, enhancing access to behavioral health services is a priority in Americas efforts towards addressing the substance abuse crisis. However, current policies have not improved the accessibility of treatment interventions. The Comprehensive Addiction Resource Emergency and Excellence in Mental Health and Addiction Treatment Expansion Acts propose radical measures that will considerably enhance the transparency, receptiveness, and the overall accessibility to behavioral health services. If implemented, the proposals can redefine the scope and delivery of behavioral health services to the community.
Various fraud and abuse cases in the healthcare industry have led to severe punishment of culprits, such as incarceration. Corruption cases in healthcare have become rampant in the US, making these illegal activities the top-listed loophole in the industry (Johns Hopkins Healthcare, n.d). Bible scriptures disregard fraudulent and abusive actions by pinning them with dire consequences. Therefore, fraud and abuse in healthcare are despicable acts that merit harsh punishment, which is reinforced in the scriptures.
Fraud is a financial deception whereby misrepresented billings are authorized for reimbursement. An example of a fraud case is the 325 million healthcare corruption scheme involving a Texas physician, Jorge Zamora-Quezada, (The United States Department of Justice, 2020). Doctor Zamora falsely diagnosed patients with chronic diseases and made him get millions of dollars unlawfully, putting this crime in the fraud category. Proverbs 15:27 asserts, Whoever is greedy for unjust gain troubles his household, but he who hates bribes will live (King James Bible, 2017). This scripture quotation depicts Dr. Zamoras current life from a respected doctor to a fugitive who has left his family in despair.
Sometimes, criminal behaviors in healthcare can be due to selfish practices resulting in the abuse of patients. Abuse is the inappropriate professional conduct of providing unnecessary medical services to patients (Johns Hopkins Healthcare, n.d). An example is when Mashiyat Rashid, a former manager at Tri-County wellness Group approved a corporate policy that allowed patients to be administered an unnecessary back injection of opioids to increase their medical bills. He pleaded guilty, was charged with four counts of abuse, and was sentenced to 15 years in prison (The United States Department of Justice, 2022). As Proverbs 21:6 mentions, Fortune made by a lying tongue is a fleeting vapor and a deadly snare King James Bible (2017). This verse indicates that wealth acquired through crime brings despair and regrets, which can be life-changing.
Child abuse, once becoming a serious socio-cultural issue, has drawn the attention of medical practitioners who serve as advocates for the communitys physical and emotional well-being. Although common for all ages, school-aged children are exposed to a higher risk of phycological abuse combined with the pressure of interaction with peers and educators. Generally, the notion of child abuse encompasses physical, emotional, sexual, medical abuse, and neglect (Mayo Clinic, 2018). Each of the aforementioned types may be recognized with the help of the following red flags :
Physical abuse may be detected through injuries that cannot be explained by a child;
Sexual abuse is recognized in childs odd sexual behavior or knowledge, blood spots on the underwear, pregnancy, and sexually transmitted diseases;
Emotional abuse is extremely hard to identify with certainty, but emotionally abused children tend to have mental disorders like depression, emotional detachment, or self-consciousness;
Neglect may be spotted through such signs as poor weight or growth, lack of essential items such as hygiene items and clothing, lack of medical care, and inconsistent school attendance records (Mayo Clinic, 2018).
Nurses should also pay attention to the behavioral patterns of a childs parents, as they may show a lack of interest in a childs health and well-being, act aggressively towards children, or limit the childs communication circle. Such behavior should be perceived as abusive and addressed by the corresponding services. Undeniably, some cases of a seemingly abusive practice may be misinterpreted by nurses. For example, some culturally specific health practices like coining or cupping leave visible bruises on the body (Killion, 2017). To avoid such misunderstandings, nurses are to be culturally sensitive and aware. However, if the signs prove to be abusive, nurses in my community have to address the Department of Children and Families through the Florida Abuse Hotline.
References
Killion, C. M. (2017). Cultural healing practices that mimic child abuse. Annals of Forensic Research and Analysis, 4(2), 1-4.
Control over such an acute problem as government abuse is an important aspect of work to ensure the activities of officials within the legal framework. Responsible agencies and coordination boards do not always do this effectively. Therefore, one of the tools that may be utilized for such monitoring is the media. In Latin America, creating the conditions for ensuring appropriate control is a relevant objective, and the media can be involved in these activities as a greater watchdog. One of the mechanisms is creating an independent online platform to collect and store essential data related to government issues. If this information is made public, the media act as an intermediary in the transmission of unbiased news to the population. In other words, cases of government abuse are captured and stored in a secure cloud environment with exclusive access to administrators. Such a measure may help reduce the level of abuse due to the threat of publicizing violations.
Another way to maintain control over government abuse through the media in Latin America is establishing partnerships with the official boards that monitor the legitimacy of the authorities work. In this case, online news portals can act as auxiliary resources and receive objective data on violations timely. The obstacle that may arise is the reluctance of the responsible agencies to share information on abuse. To address this constraint, the involvement of human rights defenders is a valuable prospect. Making demands to publish the cases of the misuse of power is natural in a society with democratic foundations and constitutional rights. Moreover, the exchange of such data can be reciprocal, and state control boards can also count on receiving relevant information from the media. Thus, creating an independent online platform and forging partnerships with state agencies are potential measures to empower the media as a greater watchdog over government abuse in Latin America.
Alcohol is an addictive substance has a significant influence of human behavior. The risk of harm for youth population age 18-29 is higher than for other age groups. The definition of the alcohol misuse is different than such terms as alcoholism and heavy drinking. Various researchers indicate different types of the alcohol misuse such as the hazardous drinking, harmful drinking and dependent drinking.
According to Midanik (2003), the alcohol misuse can be determined as the high frequency of drunkenness. In this case, drinking is harmful due to the excessive experiencing and drinking over the limits. People age 18-29 drink 8,7 times in a month. For youth population age 18-29, the level of alcohol misuse is higher than one for the elder group and, at the same time, young people need more drinks to be drunk.
Analyzing the article of Jiang (2009), it is possible to define the alcohol misuse simply as the excessive consumption of alcohol where a number of the young drinkers is higher than any other group of age due to their aspiration to the social integration and the personal identification.
For Hyman, the alcohol misuse is the harmful use of alcohol and an indication of the alcohol-dependent syndrome. Historically, the uses and misuse of alcohol influenced many people. However, all abuse problems can be treated accordingly.
Zufferey et al. (2007) concludes that the alcohol misuse can be defined as a high consumption, including the quantity and frequency, and a high-risk drinking when people use alcohol together with other psycho-active substances and drive after drinking. The level of binge drinking demonstrates that young people consume five or more alcoholic drinks in a row.
Hazardous drinking increases a number the risk factors and harmful drinking leads to the terrible consequences concerning the young people themselves. From the other hand, dependent drinking causes all the hazardous and harmful factors and becomes a basement of the increasing alcohol misuse.
According to Eschmann et al. (2011), although the alcohol misuse among youth population (18-29 years) as the high level consumption is significant today, such tendency can be explained by the age when people start their experience of using alcohol and, thereby, they demonstrate less ability to control the frequency and quantity of the use of alcohol. Besides, males show a higher level of alcohol consumption.
Schuckit (2009) defines the alcohol misuse as the harmful use of the substance that causes the morbidity and mortality, leads to the use of other drugs and substances, depressive mood, insomnia and suicide. Besides, the researcher indicates that misuse as the type of alcohol-use disorder is a medical and psychiatric problem that should be immediately treated in clinics.
Freire (2008) concludes that the alcohol misuse is a complex of behaviors that includes the episodic heavy drinking, intoxication and experience of the social problems related with alcohol. In this case, the alcohol misuse reflects more the involvement with alcohol than its regular use. For addicted young people, drinking of alcohol is a significant part of their social life, helpful tool of social integration and the personal identification.
Therefore, it is possible to conclude that all researchers provide the same opinion about a problem of the alcohol misuse, defining it as the excessive and uncontrolled consumption of the substance that leads to the serious consequences, including the morbidity and mortality.
Reference List
Eschmann, S., Zimprich, D., Metzke, C. W. & Steinhausen, H. C. (2011). A developmental trajectory model of problematic substance use and psychosocial correlates from late adolescence to young adulthood, Journal of Substance Use, 16(4): 295312.
Freire, K. E. (2008). Influence of parental socialization on adolescent alcohol misuse. US, North Carolina: Chapel Hill.
Jiang, Y. (2009). Alcoholism, Alcohol Abuse and Heavy Drinking: Irish College Males Perspectives on Alcohol-related Problems, Socheolas: Limerick Student Journal of Sociology, Vol. 2(1), 36-53.
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Substance abuse is a condition that can be prevented and treated. Substance abuse disorders impose huge financial costs to both the employer and the society at large. Substance abuse refers to the long-term pathological consumption of either drugs or alcohol. This is characterized by the intoxication of drugs, lack of ability to reduce usage, and a decrease in both the social and occupational functioning of a person. It is also apparent that substance abuse raises health care costs for the employer through high insurance premiums paid and increased on-job injuries. However, these costs can be mitigated by establishing Employee Assistance programs within the organization. The review of the literature on substance abuse and health care costs for employers will focus on these questions:
How does substance abuse impact employees work performance?
What are the concerns of the groups affected by substance abuse?
How does substance abuse relate to health care costs for the employer?
How can employers reduce health care costs?
How does substance abuse impact employees work performance
Substance abuse has a negative impact on the employees work performance. However, this impact is less on work that is repetitive in nature since less concentration is needed when undertaking them (Lewinson, et al., 2004). When an employee is abusing substances such as alcohol, his productivity significantly goes down. His performance, in general, is hampered by; his inconsistency in the quality of work produced, the slow pace at which he undertakes his duties, lack of concentration, fatigue which then leads to an increase in mistakes, poor judgment, and inability to execute complex assignments. Moreover, the increased absenteeism and late reporting to the workplace hamper the performance of both the troubled employee and of his co-workers. The performance of his co-workers is affected by the extra workload they shoulder on behalf of their colleagues. Other factors affecting the employees performance are; excessive sick leaves, more time spent on the phone, frequent early departures, and long coffee breaks (Kinney, 1995). Furthermore, employees on substance abuse are a safety threat to themselves and their colleagues because, under the influence of substances, these employees are bound to cause more accidents and injuries which directly affect their performance and increase the health care costs for the employer. Lastly, employees who abuse substances are reckless with the machines and equipment and more often damage them. All the above factors have a direct impact on the employees performance and the general performance of the business. When the productivity of employees is not satisfactory, the employer incurs huge amounts of costs ranging from wastage to the loss of the contribution that would have been brought by the unprocessed goods (Ghodse, 2005).
What are the Concerns of the groups affected by Substance Abuse
It is important to give a deep insight into the concerns of major groups of people affected by substance abuse. These groups include people directly affected by substance abuse. Among them are children and family, employer and co-workers, and the abuser himself.
When dealing with the issue of substance abuse, families should be treated as important stakeholders. This is because substance abuse has a direct impact on fundamental issues of the family. The impact is manifested in poor marital relationships which ultimately lead to a dysfunctional family. Once the family unit is dysfunctional abusive parenting behavior may creep in. The family also bears part of the cost for the members treatment and rehabilitation (Shulamith, Ashenberg & Huff, 2006).
Employers are major constituents of substance abuse because employees directly impact on the cany. Co-workers on the other hand get concerned when one of them has a problem. It is the co-workers who cover up for their colleague hence shouldering his responsibilities. They even go to the extent of lending him money and constantly correcting his mistakes (Ackley, 1999).
To the substance abuser himself, his actions may bring to him disability due to recklessness and even death. The substance abuser also stands the risk of suffering from depression because of his poor nutrition, sleeping problems, decreased energy a,nd lost job interest. The abuser is also vulnerable to health risks, of contracting HIV & AIDS, asthma, tuberculosis, and others. The abuser stands a risk of wasting his life both socially and occupationally. His loss of contribution will affect himself and the whole community (Ackley, 1999).
How does substance abuse relate to health care costs for the employer?
According to surveys conducted in the past, health care costs have increased tremendously. This means is that, the burden is largely shouldered by the employer. When employers provide health benefits to their workers, they essentially include provisions for substance abuse rehabilitation. Employers usually pay huge amounts of money through health insurance premiums and self-insuredplans for rehabilitation and treatment of their employees. When health care expenses are incurred by an employee working for self-insured companies, it is the employer who settles that bill rather than the insurer company (Klingner & ONeill, 1991). It is therefore important for the employer to constantly monitor health care costs that may show substance abuse.
How can employers reduce health care costs
The significant increase in health care costs has left employers with no choice but to reduce or control benefits to employees. One of the most effective ways to achieve this is by implementing an Employee Assistance Program (EA P). According to Milkman and Sederer (1990), health insurance claims rose up to 70%. Out of this, the employer needs to settle 54%. What employers are therefore trying to do is to mitigate their costs without necessarily affecting the quality of health care provided to their workers. Employee Assistance Program therefore helps to control health care use, quality and claims in a manner that is cost effective and does not affect the quality of the health care and access to the employees (Milkman & Sederer, 1990).
It is true that, not having an insurance cover for employees in need of treatment is an obstacle to health care access. However, even with the availability of good insurance cover, substance abusing employees may end up not fully utilizing it if they are not in contact with an EAP. EAPs provide affective avenues to getting employees who are abusing substances on treatment. They are usually effective because they concentrate on employees with jobs but need help to get out of chemical dependence. Because of the fear of losing their jobs these employees will fully commit themselves to treatment (Milkman & Sederer, 1990).
It is important to reiterate that, adopting a substance abuse program can significantly reduce the cost of business and the industry at large. As earlier mentioned these costs may be in terms of decreased productivity and increased health claims. It is also apparent that, when there is a program in place, absenteeism, injuries in the work place and mistakes committed at work are reduced to a minimal. However, it is essential to note that, several approaches are available to these programs. Each should be tailored to the individual needs of the specific companies in question (Bennett-Alexander &Hartman, 2009).
The components of a comprehensive substance abuse program should however include the following: First, there should be a written policy statement that clearly spells out the companys role in relation to substance abuse. Second, the supervisors should be trained so that they understand the companys policies and procedures on substance abuse and how they can identify and refer employees problems to the assistance available. Third, Employee sensitization on the companys substance abuse program that is at their disposal. Forth, is the companys assistance, here the company may set up its own Employee Assistance Program or seek help from outside organizations depending on its capability. Fifth, companies may decide to carry out drug and alcohol testing in order to reduce substance abuse (Bratter et al., 1995)
Conclusion
Substance abuse significantly increases healthcare cost for employers.
It is up to the employer to device a way to mitigate the impact of substance abuse to the business. In order to achieve this, there is need for the establishment of comprehensive substance abuse programs. When these programs are adopted, it becomes a win- win situation for both the employer and the employee. It is apparent that the gains from establishing a substance abuse program override the health care cost the company incurs. This is because the undertaking will completely mitigate other costs associated with substance abuse, for instance, lost productivity, on job injuries and an increase in health insurance claims.
References
Ackley, D. (1999). Breaking Free of Managed Care: A Step by Step Guide to Regaining Control of your Practice. New York: Guilford Press.
Bennett-Alexander & Hartman. (2009) Employment Law for Business. New York: Irwin.
Bratter, Thomas E. Forrest, & Gary G. (1985). Alcoholism and Substance Abuse: Strategies for Clinical Intervention. New York: The Free Press.
Ghodse, H. (2005). Addiction at Work: Tackling Drug Use and Misuse. Aldershot: Gower Publishing, Ltd.
Kinney, Jean M.S.W. & Leaton, G. (1995). Loosening the Grip: A Handbook of Alcohol Information. St. Louis: Mosby.
Klingner, D., ONeill N. (1991). Work Place Drug Abuse and Aids: A guide to Human Resources Management Policy and Practice. London: Greenwood Publishing.
Lewinson, J. Pedro R. Milkman & John, G. (2004). Substance Abuse: A comprehensiveTextbook. New York: Lippincott Williams & Wilkins.
Milkman, B., & Sederer, L., (1990).Treatment Choices for Alcoholism and Substance Abuse. Colorado: Lexington Books
Shulamith L, Ashenberg, S. & Huff F. (2006). Impact of Substance Abuse on Children and Family. Philadelphia: Haworth press