PSYC FPX 4300 Assessment Follow-on Question: Have These Drugs Ever Been Used In Combination?

Follow-on Question: Have These Drugs Ever Been Used In Combination?

Indeed, Keith often consumes alcohol and cocaine in sequence, when going to social gatherings or even on work-related events. Keith relates that he uses cocaine just to reverse the effect of alcohol that sedates him; in doing so, he manages to be lively and active despite being intoxicated. He had resorted to such more often with increasing use as work pressure became common. However, Keith admits that combining these drugs has caused him to become more irritable, and agitated, and to engage in riskier behaviors, such as poor judgment and driving under the influence. He fears the increasing dependency on both drugs and the physical toll it has taken on his health.

Medical Concerns 

Keith’s substance use has led him to several medical concerns for immediate attention. Chronic intake of alcohol likely causes discomfort to the liver, presented by infrequent stomach pain and yellowish skin. These symptoms indicate early signs of liver dysfunction or jaundice. His bingeing behavior also predisposes Keith to hypertension and cardiovascular disorder. Keith’s cocaine use compounds these risks since cocaine can significantly strain the heart, resulting in hypertension and arrhythmias that could potentially lead to long-term damage to the cardiovascular system. Moreover, Keith admits to poor sleep and excessive tiredness that can be made worse by the depressant effects of alcohol and the stimulant effects of cocaine which interfere with his natural sleep pattern. He also has loss of weight which may result from decreased appetite and poor dietary habits as related to drug use. His blackouts and loss of memory after binge drinking raise some concerns for neurologic impact, including potential brain damage due to the protracted abuse of alcohol. These medical conditions, coupled with his high-risk behaviors like driving under the influence, put him at imminent risk of accident and further deterioration in his health. The management of these medical concerns would be part of his comprehensive treatment for substance use disorder.

Past Treatment History 

Keith does not have a documented history of some form of treatment for substance abuse or mental health issues. Although he does admit having periods where he tried cutting back on alcohol on his own, those attempts failed because he had no proper support and strategies for managing. He’s never been formally treated before on account of denial and fear that he would suffer from stigma from society. Keith has no history of counseling or therapy. He admits that he was under severe stress, had mood swings, and was guilty regarding his substance use disorder and the problems he had in his personal life. This calls for the importance of devising a well-rounded care plan to tackle both the substance use disorder and emotional struggles he faces.

Environmental Factors

Residential 

Keith now resides alone in a tiny, modest apartment in the suburban area. Keith is not stable economically due to substance use and also because he has poor attendance at work, causing instability in maintaining employment. The living environment is merely furnished with minimal goods, and Keith has been feeling lonely within his home walls. Keith’s apartment is often disorganized, which he attributes to his lack of motivation and energy, common symptoms of his alcohol and cocaine use. He has stated that his house is a haven from work and social life, yet it is also a place where his substance use is more apparent. The setting without any positive social influence or recreation likely contributes to his difficulties with addiction and mental health. Keith has minimal routine and structure in his living environment, which also makes it challenging for him to maintain healthy habits or have a purpose in his life.

Social Support System 

Keith does not have an extended and tight-knit support system of social connections. His former wife is afraid for her ex-husband due to his substance abuse problem, as she also shares custody of their 8-year-old daughter. Even though Keith keeps seeing his daughter occasionally, emotional distance from his former wife has continued to increase with time primarily due to Keith’s inconsistency in the performance of expected duties. His family members, in particular his parents, are unhappy and worried but are not participating in his rehabilitation, partly because of a family history of substance use disorder. Keith has a few friends whom he is more or less getting along with from work, though the friends share similar unhealthy practices of substance use, which fuels his use. Keith is not a member of any organized social or support groups, but he did indicate a desire to seek out such a network; he just feels embarrassed or doesn’t know where to start. This lack of a positive, consistent support system adds to his feelings of isolation and makes it even more difficult for him to seek help or make recovery efforts.

Family and Family History

Family History of 

Keith comes from a family with significant histories of substance use, primarily on the paternal side. Keith’s father had an alcohol-use disorder throughout his life that affected Keith’s childhood immensely. Keith has said that most of the family conflicts and instability were related to his father’s drinking and he had seen many episodes of alcohol-related violence and neglect in his childhood. This hereditary pattern of alcohol addiction helped in Keith’s exposure at the earlier stage and built up to his dependence over time. In addition to his father’s alcoholism, Keith has an older brother who has also struggled with alcohol, though to a lesser extent. His brother has gone to treatment from time to time, but he is still fighting substance use; it has become a pattern of unhealthy coping mechanisms within the family. Keith feels that the history of substance use in his family has normalized this behavior for him, making it more difficult for him to recognize the depth of his addiction.

Family Mental Health History 

Keith’s family has a history of mental illness. His mother suffered depression and anxiety throughout his growing-up years. Keith relates that his mother often received therapy as a child, but never followed through with the treatment, which may have resulted in her continued suffering. Keith’s aunt, whom he had always known since childhood, also suffered from acute depression and was hospitalized due to suicidal thoughts on many occasions. These mental issues within his family, and most specifically the lack of long-term treatment, have contributed to Keith’s view that mental health care is transient and unreliable. He understands mental health issues within his family but has avoided exploring his mental health because he has perceived emotional difficulties as a symptom of drug use. However, the family history of untreated mental health conditions may hint that Keith is at risk of developing his own, especially depression and anxiety because he continues to struggle with addiction.

Current Additional Status to Consider

Educational 

Keith finished high school but did not go further in school because of his financial situation and lack of motivation, which he said was a result of his early substance use. He attended a technical college for a few semesters, but he stopped after facing challenges in balancing his responsibilities in school and his rising substance use. Keith, though having graduated from high school and being technically trained, feels uneducated, and this aspect of his life has triggered low self-esteem and insecurity. This is because the lack of higher education contributes to challenges in gaining stable employment and has expressed regret over the decision to not complete further studies. Keith’s educational limitation has also hindered him from relating to more sophisticated aspects of treatment or recovery since he often gets overwhelmed by reading materials or academic concepts.

Financial 

Keith is not in a sound financial condition. He was engaged in a labor manual job for low wages without benefits which added up to his insecure financial conditions. His addiction had affected him directly in going to work regularly and performing as per requirement; otherwise, he goes amiss on shifts at work and sometimes loses focus over it. Thus, Keith faces building debt, and rent problems, and cannot carry basic expenses over his living cost. He has also banked on occasional financial handouts from his family members, though they eventually ceased offering him support after he started continuing with drug abuse. Keith’s state of stress over his finances exacerbates his feelings of despondency since he now believes there is no easy way to get out of his condition. His financial life has therefore become a source of anxiety and even a hindrance to being treated since it is in private healthcare, or for rehabilitation services.

Legal 

Keith has had various dealings with the legal system stemming from his substance use behavior. In the past five years, he was involved in two DUI offenses whereby his license was suspended in both instances, and he underwent alcohol education courses as part of penalties. Keith also is at risk for legal action due to the recent confrontations at work, wherein his erratic behavior and poor judgment, no doubt triggered by his substance use, have led to threats of losing his job. These legal issues added to his stress and a sense of instability, given that he is afraid additional legal problems may jeopardize his ability to support himself and continue employment. Keith has not had any significant criminal charges yet but feels that if his substance use continues unabated, it will only lead to more serious legal problems in the future.

Motivation for Treatment 

Keith is conflicted over whether he indeed has a problem with his substance use. On the one hand, he agrees that his alcohol and cocaine use has derailed his life, particularly in his work and personal life; however, he cannot accept the fact that he has an addiction problem. He is prone to making light of his substance use, assuring himself that he can stop anytime he wants to. However, he has complained that the toll of his substance use on his physical and mental health is becoming too heavy to bear. Keith feels locked in a cycle of use wherein he uses substances to manage his stress and escape from the emotional discomforts of daily life. He recognizes some of the negative consequences but is still hesitant to fully face his addiction because he dreads the struggles that will ensue if he tries to seek help.

Keith seeks treatment because he has realized that his current lifestyle is unsustainable and is causing his quality of life to decline. He says he is tired and overwhelmed, not just physically but also emotionally, and fears losing his job and alienating his family. His reasons for seeking help are partly motivated by a concern for his daughter and a desire to be a better father and partly by fear of what his health problems may do if they continue to escalate. Keith is coming to realize that his substance use can no longer be seen as a choice but as an obsession, and at the same time, starting to become more amenable to professional help. His not knowing what this might involve or how effective this could be does not cause him to shy away because of hope that he’ll get back control of life and prevent further devastation from happening.

PSYC FPX 4300 assessment 1 Clinical Assessment 

Based on the details reported, Keith meets the diagnosis of Substance Use Disorder or SUD for alcohol and cocaine. The DSM-5 states that Keith demonstrated a pattern of substance use leading to significant impairments in social, occupational, and interpersonal functioning, characterized by a lack of control over his drinking and his use of cocaine, considering negative consequences such as job instability, deteriorated relationships, and health. Keith has also developed withdrawal symptoms when he tried to cut down, showing that he is physically dependent on alcohol and cocaine. His pattern of substance use meets the full criteria for a Severe Substance Use Disorder as alcohol and cocaine use impair his functioning and cause distress.

Besides the substance abuse disorders, Keith also has characteristics showing that he could suffer from co-occurring mental conditions, such as depression and anxiety. Feelings of hopelessness, being detached from society and being unwilling to do much prove a deep emotional struggle to Keith, which he was seeking to self-medicate by using substances. Keith has not been diagnosed with any mental health condition, but his emotional problems and destructive ways of coping suggest that integrated care that covers both addiction and mental health issues would be appropriate. His family history of mental health and substance use should be taken into consideration in designing a treatment plan because they are the probable causes of his general psychological distress.

Keith’s coping skills, to date, are very maladaptive. He is using substances to cope with stress, anxiety, and negative feelings. He indicated a pattern of isolation in which he avoids confrontation with his problems or the seeking of help. He has very few coping skills that have helped him. He is feeling helpless in many ways because he does not have consistent, healthy outlets to deal with his challenges. On the other hand, Keith has some strengths that could help him recover. He shows change. His addiction is so riddled in his life that he knows to get negative from his existence, showing concern for the young girl, knowing also when there is a dire need to get professional intervention into one’s life proves the possibility of his change since Keith can open the minds about considering treatment where first being somewhat reluctant and nonresponsive does indeed turn into such strengths upon which the healing through therapy could be nurtured. With the appropriate support and treatment, Keith can improve his coping abilities and recover control over himself.