Diagnostic Assessment: Substance Use Evaluation for Melissa

Client Name: Melissa
Assessment Date: 28/06/2023

Substance Use History: Yes

Follow-on Question:
Have These Drugs Ever Been Used In Combination?
No, my client reported using only one pill of Adderall on a daily basis. However, she admitted increasing the dosage to two or three pills during times of heightened stress. Importantly, she never attempted to combine Adderall with alcohol, cocaine, or Xanax. Such combinations were avoided due to the potential risks, including an accelerated and irregular heartbeat, possibly leading to arrhythmia, high blood pressure, and the risk of heart attack or stroke. The analysis strongly suggests that avoiding the combination of these drugs was crucial for Melissa’s well-being. Moreover, it underscores the importance of carefully monitoring drug consumption to maintain the patient’s health (Teter et al., 2006).

Medical Concerns
Melissa’s consistent use of Adderall, as well as the escalation in dosage during stressful periods, indicates an addiction to the drug. Addiction is characterized by a lack of control and engagement in harmful behaviors related to substance use disorder. In Melissa’s case, the severity of the addiction is moderate, as evident in her substance-induced depressive disorders (Hartney, 2022).

The effects of Adderall addiction include increased concentrations of norepinephrine and dopamine due to neurotransmitter reabsorption inhibition. This leads to stimulation of the sympathetic system, resulting in a fight-or-flight response with increased heart rate, dilated pupils, vasodilation, increased sweating, and nervous system activation. Combining Adderall with alcohol can lead to dehydration and increased blood pressure, potentially leading to myocardial infarction. Additionally, long-term Adderall addiction can cause permanent damage to the kidneys due to increased blood flow and vessel hardening. The constant agitation induced by the fight-or-flight response can result in anxiety and the development of other psychological disorders (Tardner, 2022).

Family and Family History
Melissa’s family history indicates her father’s alcoholism and her mother’s use of Xanax for anxiety. Although there is no direct connection between these substances and Adderall, the family history of addictive behaviors might have influenced Melissa’s inclination towards Adderall as a coping mechanism for her anxiety (Alhammad et al., 2022).

Current Additional Status to Consider
Melissa’s academic stress and the desire to secure funding for college have contributed to her anxiety. Being surrounded by friends who are also addicted to Adderall further exacerbates the situation, while her parents’ personal problems have made her feel unsupported in her struggles.

Treatment Recommendation
To effectively treat Melissa’s substance use problem, a motivating and supportive approach is vital. Detoxification can be considered to help her break free from the addiction and remove toxins from her body. Counseling, such as Behavior Change Counseling (BCC), can also aid in addressing the psychological aspects of her addiction and help her cope with academic stress (Erkekoglu & Ogawa, 2021; Dragomir et al., 2019).

Ethical Consideration
As a minor, Melissa’s consent and confidentiality must be respected during treatment. Sharing any information about her substance use without her consent would be unethical. Nursing professionals should prioritize caring, protecting, and advocating for the patient (Braun et al., 2020).

Conclusion
In conclusion, Melissa, a 15-year-old girl, is struggling with substance use disorder, particularly an addiction to Adderall. Her academic stress and lack of a strong support system have contributed to her reliance on the drug. A comprehensive treatment plan involving detoxification, counseling, and motivational support will be essential to help Melissa overcome her addiction and achieve a healthier and more fulfilling lifestyle.

References
Alhammad, M., Aljedani, R., Alsaleh, M., Atyia, N., Alsmakh, M., Alfaraj, A., Alkhunaizi, A., Alwabari, J., & Alzaidi, M. (2022). Family, individual, and other risk factors contributing to risk of substance abuse in young adults: A narrative review. Cureus, 14(12). https://doi.org/10.7759/cureus.32316

Braun, R., Ravn, T., & Frankus, E. (2020). What constitutes expertise in research ethics and integrity? Research Ethics, 174701611989840. https://doi.org/10.1177/1747016119898402

PSYC FPX 4300 Assessment 1 Whats Your Problem

Dragomir, A. I., Julien, C. A., Bacon, S. L., Boucher, V. G., & Lavoie, K. L. (2019). Training physicians in behavioural change counseling: A systematic review. Patient Education and Counseling, 102(1), 12–24. https://doi.org/10.1016/j.pec.2018.08.025

Erkekoglu, P., & Ogawa, T. (2021). Medical Toxicology. In Google Books. BoD – Books on Demand. https://books.google.com.pk/books?hl=en&lr=&id=4mwtEAAAQBAJ&oi=fnd&pg=PA311&dq=detoxification+for+drug+addicts&ots=zyNcJi5dKa&sig=_Kp-J-nkclD2ul3n7vcjVQJJyxc&redir_esc=y#v=onepage&q=detoxification%20for%20drug%20addicts&f=false

Hartney, E. (2022, August 25). DSM 5 Criteria for Substance Use Disorders. Verywell Mind. https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorders-21926

Tardner, P. (2022, April 5). Adderall and Depression. International Journal of Emergency Science and Technology. https://www.ijest.org/nootropics/adderall-and-depression/

Teter, C. J., McCabe, S. E., LaGrange, K., Cranford, J. A., & Boyd, C. J. (2006). Illicit use of specific prescription stimulants among college students: Prevalence, motives, and routes of administration. Pharmacotherapy, 26(10), 1501–1510. https://doi.org/10.1592/phco.26.10.1501

PSYC FPX 4300 Assessment 1 Whats Your Problem