drives under the influence of alcohol, it is a criminal offense abbreviated as driving under the influence (DUI). However alcohol is but one of the many substances that can interfere with one’s driving capability. DUI charges can also be pressed against individuals who are driving under the influence of other kinds of drugs, including illegal drugs and even prescription medication. Taking drugs and driving at the same time, whether the drugs are just prescription muscle relaxers or medicinal marijuana is illegal and a DUI offense. The argument that one took drugs because of doctor’s orders is not a defense to DUI charges. Various drugs have different effects on drivers. The drugs that impair concentration, judgment, alertness and/or motor skills are regarded as dangerous and in several cases even more dangerous than alcohol. Driving while having a blood alcohol concentration (BAC) of more than 0.08% or higher is illegal in the whole of the United States. Alcohol is quickly eliminated from the body so it is important to measure the driver’s BAC immediately after he is stopped (FindLaw, n.d). Frank’s BAC level was recorded at 0.18 meaning that alcohol greatly affected his judgment, alertness and motor skills.
Unlikely DUI substances
Steroids
The illegal use of steroids by professional athletes and weightlifters continues to make sports headlines as these sportsmen inject themselves with these drugs to have an advantage over other opponents. That are two main types of steroids; anabolic and corticosteroids. Anabolic steroids are hormones that are taken intravenously or orally to induce the human hormonal system to synthesize more testosterone. The main purpose of taking anabolic steroids is to build muscle mass. However one should not confuse anabolic steroids with corticosteroids which are regularly prescribed as anti-inflammatory drugs (Wedro, 2014). Anabolic steroids are known to have several harmful side effects.
Corticosteroids as mentioned above are prescribed to treat several conditions. Corticosteroids act like hormones produced by the adrenal glands to fight against stress linked to injuries and illnesses. These steroids decrease inflammation levels and also have an impact on the body’s immune system. Corticosteroids are used to treat autoimmune conditions such as multiple sclerosis (MS), asthma, arthritis, several types of cancer and skin conditions such as rashes and eczema.
Steroids are very strong medications, it therefore follows that they do have possible side effects such as cataracts and weak bones. Due to this possibility it is often recommended that there duration of use should be as short as possible (MedlinePlus, n.d).
Possible substances in the DUI
Cannabis
Amphetamines
Cocaine
Opiates
Hallucinogens
Evaluation of possible DUI substances
Opiates
There are several types of opiates that are used as drugs of abuse. They include; heroin (the most common one), codeine, methadone, morphine, oxycodone and fentanyl. Intoxication symptoms include pinpoint pupils and reduced respiratory rate. The fact that pinpoint pupils are a symptom and Frank’s pupils are dilated means that opiates are not likely to be a factor for Frank. Further acute complications that have been observed are pulmonary edema (non-cardiogenic) and finally respiratory failure. Chronic use of opiates might result in skin abscess at the point of injection, talcosis, endocarditis and mycotic aneuryms. It has been noted that the number of people snorting heroin is increasing almost every year. Its effects stated above can easily be seen and these effects do affect the ability of the motorist to operate a vehicle.
Cocaine
Cocaine is a drug that can be injected, smoked or snorted into the body. Severe cocaine intoxication causes symptoms or indicators such as hypertension, agitation, tachycardia, paranoia, tachypnea and diaphoresis. Acute and chronic use of cocaine may lead to pulmonary edema, rhabdomyolysis and even stroke. Since Frank assaulted the officer it obviously means he was agitated and agitation is one of the primary indicators of cocaine intoxication.
Amphetamines
Severe intoxication of amphetamines causes signs such as hypertension, insomnia, tachycardia and stimulation of the sympathetic nervous system (SNS).
Hallucinogens
Different hallucinogens have different effects on various organ systems. Anticholinergics for example have been linked to hypertension, tachycardia, deliriums and seizures. Phencyclidine is known to cause seizures, muscle rigidity and coma. Other hallucinogens such as lysergic acid diethylamide (LSD) do not often cause severe physical complications.
Prescription and over-the-counter drug abuse
Abuse of prescription drugs is regarded as a critical and ever increasing problem. Sedatives, stimulants and narcotics are the most abused prescription drugs. Many patients have been taken to emergency departments as a result of accidental or deliberate overdose of prescription drugs. There are a few indicators of abuse of prescription drugs, they include: numerous requests for more drugs even before the quantity that was initially prescribed could have been finished, rapid increases in the quantity of drugs required and visits to different providers (Cohagan, Worthington & Krause, 2013). Several over the counter (OTC) medications can also be abused in the same way as prescription drugs. These include those that contain benzodiazepines which can significantly affect the CNS.
Session 2
Frank did on several occasions underestimate his drug use and abuse. This could have been a result of denial which is one of the signs of substance abuse.
Provisional diagnosis using DSM-5
Substance use disorder according the DSM-5 can be defined as a problematic trend involving substance abuse that brings about considerable clinical impairments and/or distress that can be shown by a minimum of two of the following indicators within a 1 year period:
1. The medication is usually taken in larger quantities or over longer time spans that they are normally intended for.
2. Unsuccessful efforts to control drug or substance abuse.
3. A lot of time utilized in activities that are necessary to get or use the substance, or even to recuperate from its effects.
4. A craving to utilize the substance.
5. Continuous use of the substance leading to reduced ability to carry out school or work responsibilities
6. Persistent use of the substance even with recurrent social challenges
7. Reduced participation in crucial social, recreational and career activities due to substance use.
8. Persistent substance abuse even on occasions when it is physically harmful.
9. Recurrent substance use even with the recognition of a persistent physical or psychological condition that was probably caused or made worse by the substance.
10. Tolerance — a requirement for significantly increased quantities of the substance in order to get the desired effect.
11. Withdrawal indicated by a symptomatic withdrawal syndrome or use of substance or a closely linked drug to alleviate the withdrawal symptoms.
Substance Use Disorders have a threshold = 2 of 11 symptoms
Impaired control
Criteria 1-4
Social impairment
Criteria 5-7
Risky use
Criteria 8-9
Pharmacological
Criteria 10-11
Using these DSM-5 scores, we can tell that Frank’s substance use disorder is within “Risky use”
Treatment
A treatment plan for substance use disorders include various service components such as:
Group and individual counseling
Inpatient and outpatient treatment.
Residential treatment
Hospital programs
Care management
Medical prescriptions
Patient support systems
Peer support
Twelve-step fellowship
A patient who is receiving treatment may not be subjected to all of these components; however, each of them plays a significant role. These components are built upon patient-centered care and therefore every member of the community has a significant role in supporting the full recovery of patients with these disorders.
Behavioral theory
Behavioral models are based on the belief that substance use disorders are developed and sustained via basic principles of learning and reinforcement. Prior behavioral approaches with regards to substance use were based on Pavlonian conditioning and Skinnerian operant learning. However, nowadays they are based mechanisms derived from classical and operant theories of learning. A major principle of behavioral therapy is based on the fact that since substance use is a learned behavior pattern, modifying the reinforcement contingencies that control this behavior can definitely change it. This can be done by concentrating on the operant reinforcement patterns which can be considered as maintaining substance use or through conditioning craving responses. The latter method utilizes extinction and counter conditioning processes. The objective of behavioral therapy is not to bring about a new personality but to help the patient solve particular identifiable problems such that in the end the patient has the ability to apply the skills and techniques taught in therapy in their day-to-day lives (Treatment Center, 1999).
Genetic theory
In terms of genetics a person may be genetically predisposed to addiction because of genes inherited from both parents. On the occasion that this individual experiments, he or she has higher chances of developing a craving to use or become addicted to the substance even with the many negative emotional, physical and life repercussions (Understanding Substance Abuse and Treatment, n.d).
Sociocultural Theory
Socio-cultural Aspects of Substance Abuse
I must determine and analyze the variables that face a Hispanic-American substance abuser in order to meet his treatment needs in a culturally sensitive way as a care service provider. There are several variables linked to the sociocultural factors of drug abuse. Research models regarding substance use usually do not address particular demographics such as income, age, gender, geographic locations and culture. These variables are important in helping to differentiate the drug-abuse trends between and within ethno-racial groups (African-Americans, Substance Abuse and Spirituality – Minority Nurse, 2013).
Socioeconomic aspects are significant variables of Hispanic-American drug-abuse. Experts on this matter agree that socioeconomic issues such as poverty have a significant effect on the level of drug-use in the black community. A study conducted in 1992 identified illiteracy, poor education, poverty, lack of job opportunities and a high availability of drugs as the reasons behind drug abuse in the African-American and other minority groups. Other studies established that the presence of many liquor stores among Hispanic-American communities as an influence of the heavy alcohol consumption among the Hispanic-Americans. A knowledge base that is culturally relevant will take into consideration the relations between drug use and peer pressure, and the characteristic cultural behaviors, among others (African-Americans, Substance Abuse and Spirituality – Minority Nurse, 2013).
Two of the most important considerations in substance use disorders that care providers have to look into include:
1. The question of whether one can admit an individual into a treatment plan without getting their consent?
2. The balance of involving the community as much as possible in the treatment plan without compromising the patient’s confidential information
Taking these two points into consideration I will ask Frank for his consent and I will also try to involve his friends and family in the treatment plan without violating federal regulations protecting the confidential information given by the client.
Consent to Treatment
Americans largely value being left alone. They have for years developed a political and social system that sets limits on how far government agencies can interfere with what private citizens do. The right to autonomy is protected in the American constitution and courts have continuously upheld this right (NCBI, n.d).
References
African-Americans, Substance Abuse and Spirituality – Minority Nurse. (2013, March 29). Retrieved from http://minoritynurse.com/african-americans-substance-abuse-and-spirituality/
Cohagan, A., Worthington, R., & Krause, R. (2013, July 3). Alcohol and Substance Abuse Evaluation . Retrieved from http://emedicine.medscape.com/article/805084-overview#aw2aab6b3
FindLaw. (n.d.). Driving Under the Influence of Drugs – FindLaw. Retrieved from http://dui.findlaw.com/dui-charges/driving-under-the-influence-of- drugs.html
MedlinePlus. (n.d.). Steroids: MedlinePlus. Retrieved from http://www.nlm.nih.gov/medlineplus/steroids.html
NCBI. (n.d.). Treatment of Adolescents with Substance Use Disorders. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64357/
Treatment Center (1999). Brief Interventions and Brief Therapies for Substance Abuse. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64948/
Understanding Substance Abuse and Treatment (n.d.).http://www.google.com/url?q=https://www.liveandworkwell.com/member/library/guides/substance_abuse.pdf&sa=U&ei=7tBRVaL5LcKBUdT3gfAM&ved=0CCEQFjAC&usg=AFQjCNFzyF18OJYFjiKdapqYJwzlfCoJAg
Wedro, B. (2014, July 29). Steroids: Get Facts on the Drug and Its Side Effects. Retrieved from http://www.emedicinehealth.com/steroids/article_em.htm
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