Patient Background
Marcel is a 21-year-old African-American man who self-referred for inpatient treatment due to drug and alcohol abuse. He is currently unemployed, homeless, and has charges pending due to a number of “bounced” checks written over the past several months. Marcel reports that both of his parents were drug addicts, and he experienced physical, sexual, and emotional abuse throughout childhood at their hands. His father died of liver disease at the age of 37.
Potential Diagnoses for the Patient
Based on Marcel’s self-reported symptoms and behaviors, along with observations made during the assessment process, my initial diagnostic impression is that he meets the criteria for Substance Use Disorder (SUD) as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (Jahan & Burgess, 2022). Substance use disorders frequently appear with other mental health issues, including anxiety or depression (Jahan & Burgess, 2022). Dual diagnosis or comorbidity refers to this phenomenon. It would be crucial to determine whether he has any underlying medical illnesses or physical health issues in addition to SUD that might affect his treatment strategy.
Targeted Clinical Interview for Diagnostic Relevance
It is essential to clarify Marcel’s drug usage history. Not only does it include the drugs he has consumed, but also the amount and frequency. It is also crucial to inquire about any prior attempts to stop using drugs or alcohol, as well as any previous involvement with treatment facilities.
Another critical area to explore is Marcel’s social support system. Does he have friends or family members who support his decision to seek treatment? Is he involved in any support groups or other recovery-oriented activities? Being aware of the degree of assistance he has access to can make planning his treatment and identifying potential obstacles to success more accessible.
Given that Marcel self-identifies as bisexual, it is also crucial to investigate any problems with Marcel’s sexual orientation that could be affecting his drug usage. For example, does he feel isolated or stigmatized within the LGBTQ+ community? Has he experienced discrimination or harassment based on his sexual orientation? These elements may add to tension and worry, which may raise the chance of substance misuse.
In addition to these areas of investigation, the following questions may be especially pertinent for Marcel, given his background and identity:
- Have you ever felt like your sexual orientation was a factor in your substance use?
- Has stigma or discrimination based on your sexual orientation negatively affected your mental health?
- Have you ever thought that using drugs or alcohol was a coping mechanism for stress or anxiety associated with your sexual orientation?
- Are there any LGBTQ+-specific resources or support groups that you have found helpful in the past?
These and similar questions during medical assessment will help me, as a health professional, develop a more thorough understanding of Marcel’s background and requirements. These elements will help guide treatment decisions and specify the path to recovery. Additionally, the evaluation procedure must be approached with cultural awareness and competency.
Reference
Jahan, A. R., & Burgess, D. M. (2022). Substance use disorder. PubMed; StatPearls Publishing. Web.