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Substance Use Disorders: Classification and Treatments Case Study


Etiology/Pathophysiology/Incidence/Prevalence

Cocaine and methamphetamine abuse is a health challenge affecting many people across the globe. In terms of etiology, there is no relationship between genetic constitution and substance dependency. However, some scholars argue that there are genes characterized by allelic variants that encourage drug abuse. These two substances inhibit the re-absorption of catecholamines. They also activate the body’s DNA to produce high quantities of calmodulin-kinase II. This results in increased quantities of calcium in the cytosol and myocardial hypertrophy. When it comes to prevalence, these substances are taken the most by individuals aged between 12 and 25 years of age. People aged 18-25 years are widely affected by these substances at 5.6 percent. The National Survey on Drug Use and Health (NSDUH) indicates that around 0.6 percent of individuals aged above 12 years begin to use cocaine and methamphetamine annually.

Differential Diagnosis

  • Acute Respiratory Distress Syndrome (ARDS)
  • Acute Coronary syndrome
  • Anticholinergic toxicity
  • Amphetamine toxicity
  • Dilated cardiomyopathy
  • Hallucinogen toxicity
  • Hypertensive emergencies
  • Myocarditis
  • Seizures
  • Subarachnoid hemorrhage
  • Sympathomimetic toxicity
  • Pediatrics, Tachycardia
  • Personality disorders
  • Stroke, Hemorrhagic
  • Stroke, Ischemic
  • Toxicity, Thyroid hormone

Evaluation

Individuals who are addicted to alcohol, marijuana, and other addictive drugs should be evaluated for cocaine and methamphetamine use. When evaluating the abusers of these two substances, physicians should begin by monitoring their health histories. Some of the common signs include poor personal hygiene, odor, anxiety, weakness, and tiredness. Urine toxicology should be done to identify the presence of these substances in the body.

History

Physicians should query suspected patients about their use of methamphetamine and cocaine. Addiction treatment information should also be gathered. It is also appropriate for caregivers to monitor the social, medical, or family history of every drug abuser.

Physical Examination

Cocaine and methamphetamine abuse/toxicity in a given patient can be identified with the help of efficient physical examination. Cocaine and methamphetamine abuse can result in immediate effects such as increased heart rate, irritability, and anxiety. Individuals who use these substances might appear sweaty or tired. Prolonged use of methamphetamine and cocaine can result in increased blood pressure. Body temperatures also increase significantly. The drug abuser will have a reduced appetite. Other short-term effects include hyperactivity, wakefulness, and increased respiration. Chronic use of these substances can affect a person’s hygiene and nutritional status. Some physical signs such as bruises, lacerations, jaundice, physical injuries, rashes, and needle marks are common in users of the drugs. These signs and symptoms should be used to inform the best care delivery and treatment models for targeted individuals.

Diagnostic Studies

Laboratory Evaluation

Laboratory examinations are important when diagnosing abusers of cocaine and methamphetamine. The common laboratory evaluations test blood and urine samples to come up with adequate medical inferences. A complete blood count (CBC) is done to assess electrolyte and renal function. Levels of serial troponin are examined to detect myocardial ischemia. Childbearing women can qualify for pregnancy tests. Laboratory toxicological screens are used to study a patient’s drug history.

Imaging

Neuroimaging has become a common practice in the field of medicine to study the behavioral and cognitive components of addiction. This form of imaging is currently being done by researchers to investigate the behaviors of persons addicted to different substances such as cocaine. Some of the common imaging techniques include electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). Future imaging techniques are expected to be personalized in an attempt to aid in the delivery of quality patient care.

Treatment

Therapies are used as powerful treatment methods for cocaine and methamphetamine addiction or toxicology. Personalized counseling, drug testing, family education, and empowerment are also useful treatment methods. Another model known as Motivational Incentives for Enhancing Drug Abuse Recovery (MEIDAR) has been observed to promote cocaine and methamphetamine abstinence. Drugs such as bupropion, naltrexone, and modafinil encourage patients to reduce the use of these addictive drugs.

Expected Outcome/Follow-Up Needs

Physicians embrace the use of different interventions to meet the needs of patients who are addicted to methamphetamine and cocaine and those who have developed toxicity. Doctors usually expect their patients to show positive results within a short period. Some of the expected outcomes include reduced use of these substances, improved personal hygiene, and desire to pursue personal goals. The targeted beneficiaries should be able to re-pattern their lives and avoid these addictive substances. Follow-up needs include education, provision of appropriate drugs, and monitoring of every patient’s progress. Evaluation should be done continuously to identify patients who might not be using specific drugs effectively. The ultimate goal of such interventions is to empower more addicts and encourage them to stop the malpractice.

Patient Education

It is appropriate for patients to consider the above laboratory and physical examinations. Follow-up for clinical and laboratory sessions is recommended. Counseling and behavioral therapy should be taken seriously. Training sessions should focus on the dangers of these drugs, the best medicines to take, and appropriate behaviors that can encourage individuals to abstain. Patients should inform their family members and relatives about their health gains. Medications should be taken as prescribed. Family members should seek immediate medical attention whenever their patients’ conditions get out of control.

References

Forray, A., & Safuoglu, M. (2014). Future pharmacological treatments for substance use disorders. British Journal of Clinical Pharmacology, 77(2), 382-400. Web.

Keyvanara, M., & Monadjemi, S. A. (2016). Simulating brain reaction to methamphetamine regarding consumer personality. International Journal of Artificial Intelligence & Applications, 6(4), 63-72. Web.

Robinson, S. M., & Adinoff, B. (2016). The classification of substance use disorders: historical, contextual, and conceptual considerations. Behavioral Sciences, 6(18), 1-23. Web.

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IvyPanda. (2020, November 27). Substance Use Disorders: Classification and Treatments. Retrieved from https://ivypanda.com/essays/substance-use-disorders-classification-and-treatments/

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1. IvyPanda. "Substance Use Disorders: Classification and Treatments." November 27, 2020. https://ivypanda.com/essays/substance-use-disorders-classification-and-treatments/.


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IvyPanda. "Substance Use Disorders: Classification and Treatments." November 27, 2020. https://ivypanda.com/essays/substance-use-disorders-classification-and-treatments/.

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IvyPanda. 2020. "Substance Use Disorders: Classification and Treatments." November 27, 2020. https://ivypanda.com/essays/substance-use-disorders-classification-and-treatments/.

References

IvyPanda. (2020) 'Substance Use Disorders: Classification and Treatments'. 27 November.

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