One drug is frequently linked to the phenomenon of substance usage. The bulk of users does indeed abuse just one substance. Although, more patients and clients are being diagnosed with multiple substance use. Polysubstance Dependence was a diagnostic term in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. It meant using several drugs without giving any specific preference to any of them.
Nevertheless, this diagnosis has been dropped in the most recent edition, the fifth. This is the result of years of research and cares for these ailments. As a result, the DSM-5’s current diagnostic standards are categorized under the broad category of substance use disorders. The diagnosis is made in this case and accordance with the DSM-5 by identifying the specific substance being used and the intensity of the use. Rankings range from mild to severe for this severity. It is important to remember that multiple substance use disorder and polysubstance dependency are distinct conditions because the latter involves the co-occurrence of separate multiple substance use disorders.
This essay examines two case studies of a 16-year-old girl and a 26-year-old man with numerous substance use disorders. The DSM-5 Adolescent & Addiction Textbook’s current environment serves as the setting for this. The defining characteristic of drug use disorders is the persistence in taking the problematic substance despite whatever problems it may be causing. The disease can range in severity from minor to severe. With mild having two to three symptoms, moderate having four to five symptoms, and extreme having six or more symptoms, this may, of course, alter with time, either for the better or for, the worse. The abused substance is classified by the codes used for diagnosis, but the diagnosis’s narrative includes the substance’s actual name.
Maria, a 16-year-old student, continues to reside with her parents. She consumes cocaine, booze, and weed. With distinct co-occurring substance use disorders, this is multiple substance use. She is exhibiting the following indications and symptoms of alcohol use:
- She has noted that she is consuming more alcohol daily, indicating tolerance.
- She has a strong desire to keep drinking no matter what; she does so despite the possibility of damaged relationships and social issues with her parents.
- Their response when they discovered cannabis in her room is proof of this.
These symptoms appear to fit the diagnostic criteria listed in the DSM-5, which is A. Maria’s substance usage is consequently classified as light because she is only exhibiting three symptoms at most. According to the DSM-5, her diagnosis is Mild Alcohol Use Disorder (Essau & Delfabbro, 2008). The signs she is showing for cannabis use, on the other side, are tolerance, need, and ongoing usage despite the social issues it causes between her and her parents, and these symptoms satisfy diagnostic criteria A according to the DSM-5. As just three symptoms at most are present, the diagnosis of Mild Cannabis Use Disorder still falls under the mild category. Maria has not yet received a cocaine use diagnosis because her cocaine use did not fulfill any diagnostic standards.
Terry, a 26-year-old Caucasian male who uses cocaine, alcohol, and cigarettes, is also a smoker. This is also multiple substance usage with blatantly present co-occurring problems. He has failed to stop drinking (he gave up the habit two years ago but has resumed), spends much time finding, ingesting, and recovering from alcohol, also he continues to use alcohol despite having interpersonal issues. His symptoms of alcohol use include tolerance (he does not feel the effects of the alcohol until after the sixth bottle) and craving. Moreover, despite being aware that alcohol may exacerbate his hypertension, he continues to drink. The diagnostic requirement A is satisfied by this symptom profile. Given that there are six symptoms and a diagnosis of severe alcohol consumption disorder, the severity specifier for this condition is severe.
Terry, on the other hand, exhibits craving, tolerance, repetitive cocaine use that prevents him from meeting his socioeconomic commitments (he is unemployed and has a tense relationship with his girlfriend at home), disregard of critical tasks, interpersonal issues with rage and hostility, including antagonism towards his girlfriend, and spending much time looking for, using, and recuperating from cocaine. These signs meet requirements A, and given the six symptoms, the severity specifier is severe. Thus, severe cocaine use disorder is the diagnosis. James displays the following signs of tobacco use: tolerance, yearning, spending much time getting and using the tobacco and continuing to use it while being aware that it worsens his high blood pressure. These symptoms meet the DSM-5 diagnostic standard of type A for tobacco use disorder (Essau & Delfabbro, 2008). Given that four symptoms are present, the severity specifier is moderate. Therefore, mild tobacco use disorder is the proper diagnosis.
For several reasons, the age of the client or patient is crucial when determining the diagnostic standards and the conclusive diagnosis. The two most significant ones are that knowing the patient’s age is necessary to tailor individual treatment modalities for the most effective evidence-based strategy and that psychotherapeutic strategies like cognitive behavioral therapy, or CBT, need to know the patient’s age to be specifically tailored to their needs. One question to ask Maria would be, “Do you typically use marijuana to forget about troubles you have or to have fun?” In Terry’s case, some of them would be “Do you get up at night to smoke tobacco?” and “Do you have trouble recalling recent events?”
The DSM-5 criteria fit Terry and Maria’s presentations reasonably well. It is thus simple to determine the severity and get a diagnosis after determining the symptoms and their quantity. The difficulty in this type of diagnosis, as seen by these two case examples, is that there is no single diagnostic statement; instead, it is a composite diagnosis. As it was already mentioned, these results from the fact that both use multiple substances. Maria has mild alcohol use disorder and mild cannabis use disorder, and it can be inferred. Terry suffers from moderate tobacco use disorder, severe alcohol use, and severe cocaine use disorder.
Reference
Essau, C. A., & Delfabbro, P. (2008). Adolescent addiction: Epidemiology, assessment, and treatment.