SUBSTANCE USE DISORDERS2 Introduction Substance use disorders consist of impaired control over the use of drugs with sustained use notwithstanding significant psychological and physical difficulties. Substance use disorders can either be dependent or harmful. Dependence use is related to symptoms such as tolerance to the consumption of alcohol and drugs and suffering from withdrawal symptoms among others (McGorry, Purcell, Goldstone, & Amminger, 2011). On the other hand, harmful use involves the use of a drug until it leads to physical or psychological harm. According to the Australian Institute of Health and Welfare (2020), there was an increase in the number of smokers who had developed mental health conditions and psychological distress between 2013 and 2016. The survey reported 22% of chain smokers and who were twice likely to develop severe psychological distress than non-smokers. The percentage of tobacco smokers increased between 2013 and 2016 and this corresponded with an increase in mental sickness and psychological distress by at least 5%. Consumers of alcohol self-reported higher levels of psychological distress (16.1%) than non-alcoholics (9.3%) (Calabria et al., 2010). Background My name is Amelia and I am a female college student aged 25 years old. I am an Indigenous Australian of the Gadigal descent living in Sydney. I currently stay alone but usually pay visits to my parents and siblings in the northern part of Sydney. I was born and raised in Sydney, though my parents moved to the city thirty years ago. I am light-skinned, blonde-haired and four-five inches tall. I work part-time in the restaurants within the city and also attend college. My leisure activities include binge drinking, smoking, and clubbing. Since I am a student and part-time worker, I only get involved in the pleasure activities during the weekend.
SUBSTANCE USE DISORDERS3 I aspire to be a registered nurse in the future so as to offer healthcare services to the Indigenous Australians who are so preservative to their culture. I do not ascribe to any religious beliefs neither do my parents. My major regrets in life are attributed to my lifestyle. I regret the first time I tasted alcohol and had the first puff of cigarette smoke. It was out of peer pressure but little did I know that it will reach the present condition of addiction. Furthermore, my addiction to substance use has led me to a lot of trouble including arrests and accidents. I could also smoke at intervals of three house whether at work or school. Blog Entries Blog 1: Dependence and risk factors I remember it was on a Friday evening after I had checked-out from my work station and received an invitation call from my friends to a party. I quickly rushed to my house, dressed up and left for the party. The only thing I remember is my arrival to the party and the first few bottles of alcohol that I drank because I found myself on a hospital bed the following day. Nurses told me that I drank too much alcohol until I became unconscious. It is at this point that I began to realize that I was developing a dependence on substance use. The physician came and asked me several questions including how frequent do I drink or smoke, whether there is an increase in the use of the substance, how I manage to drink, party, attend school and work, and any risk factors that I am aware of (Hasin et al., 2013). I was introduced to drug and substance abuse by my friends who potentially influenced my beliefs about drugs. I can also attribute my drinking to the early influence of my parents who also drink regularly. I used to see my parents drink at home over the weekends, even though we were not allowed to taste. After the diagnosis, the doctor called my parents and notified them of the incidence and I was discharged and advised to watch my lifestyle.
SUBSTANCE USE DISORDERS4 Blog 2: Academics and Mental Health It took me just two days, and I couldn’t imagine life without smoking or drinking alcohol. I was summoned by my parents following the doctor’s call and they talked to me for almost four hours regarding my growing dependence on substance abuse. They cited its effect on my academics. I had been twice warned about my absenteeism from school (Balsa, Giuliano, & French, 2011). I initially used to drink on weekends only but now I can’t miss a day without drinking or smoking. As a result, I could drink the previous night and yet I should attend classes the following day in the morning but only to wake up late. Consequently, there was a significant decline in my grades and at the end of the semester, I couldn’t proceed to the next year because I had to retake some units in which I had failed. I could neither pay my bills nor progress at school, and as a result, I began to develop depression which further increased the frequency of smoking and alcohol drinking. Blog 3: Withdrawal symptoms and social life It was inevitable that I needed urgent help to address my addiction to drug and substance abuse. I effortlessly attempted to reduce the frequency of drug and substance use to no avail. Unfortunately, I suffered from withdrawal symptoms such as insomnia and poor concentration and memory. I even used to forget my class schedules and could only remember after being called by a classmate. I couldn’t sleep despite feeling sleepy and restless. Furthermore, my social life became much more complicated. I couldn’t relate well with my siblings, parents and had experienced two break-ups within three months. Both the consequences of dependence on drug and substance use and withdrawal symptoms necessitated the need for professional healthcare services. I informed my parents about the condition and they sought a psychiatrist who recommended a cognitive behavioral therapy program. We agreed with the doctor when to begin
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SUBSTANCE USE DISORDERS5 the sessions with an assurance to my parents of my desire to quit smoking and alcohol consumption. Blog 4: Cognitive-behavioral therapy (CBT) Having experienced the effects of dependence on drug and substance use in addition to my failed attempts to overcome the condition, I was ready and willing to follow the doctor’s recommendation to the latter. The CBT program was carried out at the doctor’s clinic and sometimes via the internet. The program consisted of several interventions with each of them having different aims. I had to give up work and attend all the ten sessions which would last for ten weeks. The doctor began with motivational interventions that were aimed at ensuring adherence to the treatment (McHugh, Hearon, & Otto, 2010). Then followed by a contingency management approach that was aimed at countering the strong underpinning effects of the drug. The doctor used non-drug reinforcers such as shopping vouchers (Petry & Alessi, 2010) and physical demonstration of abstinence from drugs as well as increasing reinforcement schedules in which the value of the reinforcer rises with the increase in the duration of abstinence. The relapse prevention technique (Witkiewitz, & Bowen (2010) was also used in which the physician-assisted me in identifying and preventing high-risk situations such as hanging out with my drinking friends or receiving their calls over the weekend. By the end of the first five weeks, I was no longer suffering from the withdrawal symptoms and I believe that by the completion of the CBT session, I will have managed my situation and gone back to track Conclusion I have gained a lot of insight through this task of blog writing. I have learned that substance use disorders is an existing reality that affects the health and wellbeing of youths and
SUBSTANCE USE DISORDERS6 even ruins their life at a tender age. Substance use disorders affect the whole life of an individual and have a significant effect on daily activities such as work, school, and social relationships. However, some individuals are at a higher risk of developing the condition due to the pre- existing risk factors such as peer pressure, parental influence, depression among others. My newly acquired knowledge on the effects of substance use disorder and the potential risk factors will be critical in my future nursing practice. I will use this knowledge to offer counseling sessions to victims and those not yet affected by the condition as a preventive mechanism. The specific nursing actions that I would like to practice in the future include the creation of awareness on substance use disorders and risk factors in schools, develop strategies for early intervention and prevention, and exercise empathy while dealing with victims of substance use disorders. I will create awareness of substance use disorders among the youths by developing school-based programs in which free counseling sessions are offered to the students. Additionally, I will recommend free counseling sessions to young parents visiting the maternal care unit on the impact of parental role on drug and substance abuse on children. I also intend to conduct more research into the most effective strategies for early intervention and prevention of substance use disorders. This is because had there been an early intervention in the case of Amelia, her condition could not have worsened.
SUBSTANCE USE DISORDERS7 References Australian Institute of Health and Welfare(AIHW). (2020)‘Alcohol, tobacco & other drugs in Australia’, Cat. no:PHE 221.Canberra: AIHW. Available at: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/priority- populations/young-people(Accessed: 16 April 2020). Balsa, A. I., Giuliano, L. M., & French, M. T. (2011)‘The effects of alcohol use on academic achievement in high school’,Economics of education review,30(1), 1-15. Calabria, B., Doran, C. M., Vos, T., Shakeshaft, A. P., & Hall, W. (2010) ‘Epidemiology of alcohol‐related burden of disease among Indigenous Australians’,Australian and New Zealand journal of public health,34, S47-S51. Hasin,D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., ... & Schuckit, M. (2013), ‘DSM-5 criteria for substance use disorders: recommendations and rationale’,American Journal of Psychiatry,170(8), 834-851. McGorry, P. D., Purcell, R., Goldstone, S., & Amminger, G. P. (2011) ‘Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care’Current opinion in psychiatry,24(4), 301-306. McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010) ‘Cognitive behavioral therapy for substance use disorders’,Psychiatric Clinics,33(3), 511-525. Petry, N. M., & Alessi, S. M. (2010)‘Prize-based contingency management is efficacious in cocaine-abusing patients with and without recent gambling participation’Journal of substance abuse treatment,39(3), 282-288.
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SUBSTANCE USE DISORDERS8 Witkiewitz, K., & Bowen, S. (2010)‘Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention’Journal of consulting and clinical psychology,78(3), 362.