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Homework answers / question archive / Week 1 Project Instructions Based on your understanding of the week’s materials and relevant research, address the following in a 4- to 5-page Microsoft Word document: How have federal and state regulations mirrored societal focus on substance use? What are the current legal standards with regards to substance treatment? Consider legal issues such as confidentiality, informed consent, referrals to treatment centers, insurance coverage, release of information, etc
Week 1 Project Instructions
Based on your understanding of the week’s materials and relevant research, address the following in a 4- to 5-page Microsoft Word document:
Read the two case studies below. Then answer the questions in a Word document.
Case Study 1
Staria is a seventeen-year-old girl who has been brought to your outpatient treatment center by her mother. Staria has been suspended from high school on two occasions over the past six weeks for fighting and disorderly conduct. She has a history of recurrent detention and classroom dismissals for similar, though less severe, behavior at her previous high school. On the last occasion, she and another student were engaged in an altercation in the hallway. When security was called in, it was discovered that Staria had a pint of vodka and a small quantity of marijuana in her locker. At the time, it was noticed that Starina seemed intoxicated. She later tested positive for marijuana.
You meet Staria and her mother and learn that Staria stole alcohol and marijuana from her father's stash and that he was outraged by the discovery. Staria blames her parents for her school dismissal and feels she is being blamed and scapegoated by her parents. According to her, her parents are the ones who need counseling. She also reports that her grandfather recently passed away due to cirrhosis. Her mother states that Staria has a twin sister, who never uses drugs, cigarettes, or alcohol and that Staria should be more like her sister.
Case Study 2
George is a civil service employee who has been struggling with his drinking problem for years. He has tried to control his alcohol use and has made many attempts to refrain. Lately, he has been drinking more frequently to feel the same effect; he even drinks before he goes to work. His family has a history of alcoholism. Although George is aware of the genetic origins concept, he feels embarrassed and struggles to identify himself as an alcoholic. He compares himself with others who drink far more than he does, and in his perception, this rationalizes that he is not that bad.
George continues to drink despite the adverse consequences on his health and sociocultural relationships. In the past three years, he has experienced the following consequences:
George's present employer asks him to attend Alcoholics Anonymous meetings. George responds, "I am not like those people. I am not that bad."
Based on the case studies given above, create a Microsoft Word document that answers the following:
The perceptions and intentions of both the government and society resonate with identifying drug abuse as abnormal and illegal. The agreement of both parties on the issue is evident in history and still prevalent to date. People had religious beliefs, social conventions, and regulations in place that prohibited the usage of certain drugs. In the face of the increasing diversification of societies and individual rights, such earlier limitations do not have the prominence they once had (Sacco, 2014). Individuals have a heightened tendency to disregard conventions and regulations in favor of seeking out individual rights that may contradict existing policies. Legalizing recreational drugs is one movement whose structure and idealism resonate with fights for civil rights, women's rights, and African American identity. The priority for legalizing recreational drugs resonates with other such revolutions in forcing the government to yield to the concerns of the majority, regardless of earlier policies or declarations.
The contemporary United States defines the current state of substance abuse and dependency as a public health crisis. The definition allows for the expenditure on scientists to find current and potential evolving factors that contribute to the problem. The consideration for misuse of illegal and prescription drugs considers social and individual elements in the evaluation (Fisher & Jaber, 2019). The approach also extends the mandate of scientists to provide informative preventive and treatment strategies that can inform public health policies moving forward. The definition of the current state of events as a crisis also informs on the collaboration of people and communities with state and federal governments directed at helping reduce the prevalence of substance abuse. The laws and regulations formed coined from such initiatives prohibit the manufacturing, possession, and distribution of various drugs, notably those identified as recreational drugs. Notable exceptions to such mandates and policies include alcohol and tobacco.
The actions by President Nixon set a precedent and made him a pioneer on policies regarding drug abuse and misuse. The president and his administration drove and passed the Controlled Substances Act (CSA), which informed their intention to have more federal authority about the control of drugs (Sacco, 2014). The CSA highlighted that federal jurisdiction was the supreme authority that governed civilian conduct about identified drugs, plants, and chemical substances. Congress also took such actions to either entirely replace or partially combine several existing drug laws and regulations into one to favor a single or unified approach. The CSA classified the controlled into five groups, based on their use in medical interventions, their potential for addiction and abuse, and the danger that each of them posed to the population (Sacco, 2014). President Nixon further established the Drug Enforcement Agency (DEA) in 1973 and made the CSA a significant backbone to the organization. The CSA formed the legal framework that defined the authority of the DEA and their regulatory mandate over controlled substances
The state and federal regulations have also exhibited a similar need for control and prohibition of clinical drugs. The policies that guide conduct on such drugs allow for civilian production, possession, and distribution but involve a lot of power from regulatory bodies. The involvement of both forms of government highlights an increasingly comprehensive approach that acknowledges the primary foundation of such policies as prevention, treatment, and enforcement. President Reagan also set the same course, following the footsteps of President Nixon in fighting drug misuse in the United States. Reagan's administration demonstrated its dependency on the criminal justice agencies to fight against drug abuse (Sacco, 2014). Reagan's policy favored the establishment of the Comprehensive Crime Act of 1984. The regulation improved on the existing penalties for violations of existing controlled substance laws. The Act also revised selected felony drug violations to include general criminal forfeiture provisions (Sacco, 2014). Recently state and federal regulations have turned their attention towards supply reduction, which has included the intentions and opinions of local communities. Nevertheless, the purpose of either of the bodies in the past continues to be on the control of drugs. The State and Federal governments mirrored the social concerns for drug abuse and misuse through regulations prohibiting defined actions and criminal policies governing the penalties accrued by individuals for violating the established laws.
The current legal framework that guides substance abuse treatment acknowledges such conditions as a significant challenge. One such policy in existence is informed consent that guides such matters as confidential limiting disclosure on the individual's name. The reasoning in favor of such policies is to protect recovering individuals against undue discrimination and social stigma. In addition, the regulations are in place to motivate willing candidates to participate in treatment (Sacco, 2014). Consequentially, the confidentiality and informed consent regulations also protect the information about individuals against circulation. The laws achieve such a mandate by restricting communication of the patients involved in diagnosis, treatment, or referral for treatment by programs offering such practices. The policies are highly sensitive and just as significant in caring for these groups of individuals. The state and federal confidentiality regulations are mandatory for every organization and program that seek to help substance abuse patients through counseling, treatment, or referral services.
The regulations apply even to former clients. Such provisions protect the patient information held by the programs or organizations against subpoenas and search warrants. The protection of individual information only allows disclosure if the individual whose information is in such programs signing consent forms allows for distribution (Sacco, 2014). Other exigent conditions could warrant disclosure without consent from the individuals, such as medical emergencies. Other requirements include the need to report to authorities (such as the cases involving abuse or neglect of a minor), the presence of danger to self or others, or in situations of communication among staff involved in the program (Sacco, 2014). The protections offered do not protect disclosure in medicine requirements and release of information necessary for the prescription. However, such information should be disclosed using medical terminology.
The disclosure of information also warrants consideration to insurance policies and mandates. Patients would have cover if diagnosis of the disease or illness came after taking the insurance cover. However, the patients have to disclose their condition to the insurance if they had the situation before taking the insurance cover. The provider might deny any claim where the individual lacked to reveal their underlying condition under the provision "rules of suppression of facts" (Sacco, 2014). The length and permissible length of insurance cover for such health conditions depend on the diagnosis's seriousness but typically comes about following a structured waiting period. The current focus on the confidentiality of patients and their protection after leaving counseling and treatment programs marks a shift in attitude towards drug abuse, but further improvement is necessary to include mental health provisions.
The DSM-5 contains various signs and symptoms valuable to diagnose different psychosocial cases brought about by substance abuse. Using the manual, the diagnosis for Staria would be as follows;
The diagnosis of Staria is with code 292.9 (F12-99), unspecified cannabis-related disorder). The manual asserts the diagnosis on individuals whose symptoms are not adequate for the diagnostic criteria of any certain cannabis-related disorder but have the symptoms. The exclusion is also relevant for any other conditions that are addictive and classified under the substance-related diagnostic class. The DSM-5 manual asserts that the individual in the classification has symptoms characteristic of the cannabis-related disorder. Such symptoms have to bring about clinically significant impairment or distress in functioning, including occupation, social, and other notable areas. Staria demonstrates signs and symptoms of tolerance, use, and intoxication brought about by the use of cannabis. The behavior of the patient highlights psychological factors influencing her habits
Staria's case meets two of the three risk and prognosis factors that contribute to the complete requirement of cannabis-use disorder. At 17, the teenager meets the temperamental criteria through problematic conduct for more than six weeks. Her current school records six weeks of problem behavior that have to lead to class dismissals and two suspensions. The case study also has environmental factors, including unstable family and academic failure. The educational problems arise from her frequent detentions and class dismissals in her previous school. The instability in her home is evident by Staria blaming her parents for her conduct and feeling that she is a scapegoat. Her father also smokes marijuana and drinks alcohol, so the teenager has easy access to the drugs. Also, Staria's mother demonstrates that she constantly compares the teenager to her twin, implying favoritism. However, Staria has no symptoms that qualify her behavior and condition as a cannabis-use disorder.
Under the DSM-5 manual, George's diagnosis is Alcohol use disorder. The manual highlights that the prevalence of the symptoms borne from a problematical pattern of alcohol use must be present within 12 months. The individual meets the criteria since he has had alcohol-related problems for years. George also surpasses the minimum standards limit of two that identify the diagnosis as alcohol use disorder. The individual meets the first criterion because he recently finds that he needs to increase his alcohol intake to get high. His drinking problem has also lead to his arrest while intoxicated and fights and arguments with family members. The consequences highlight social and interpersonal impairments which can be either caused or exacerbated by alcohol consumption. George's drinking habits have affected his performance at work to the point he lost his job.
George's resistance to identifying as a drunkard is to compare himself with others he perceives to be worse drunks than him. He uses logic to rationalize that he is not as bad as other alcoholics, which informs denial and lacks any withdrawal signs. The resistance also meets the ninth criterion because it asserts that George is aware of his problem behavior but uses excuses to justify his habits instead of seeking treatment. George has a high tolerance for drinking but does not manifest any signs of withdrawal. The information presented informs that George meets 7 of the 11 criteria used to diagnose alcohol use disorder, of which the minimum is 2. Under the diagnostic manual, George meets the qualifications of a severe condition 303.90 (F10.20).
