Working with Nic: Professional & Ethical Considerations - Essay Sample

Introduction

My initial impression of Nic is that he was stressed and his childhood circumstances drove him to his drug addictions. His parents had divorced and even David, his wife, acknowledges that no child would benefit from a bitter and savage divorce like the one they had (Taylor, 2019). Nick was affected by the divorce and his relationship with his stepmom was not good.

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Professional and Ethical Considerations when Working with Nic

When working with Nic, several professional and ethical considerations need to be adhered. The first ethical consideration is confidentiality; it can have greater negative consequences in the therapeutic process. It is important to have as a premise the respect for the privacy of the addicted patient (Fisher & Jaber, 2019). For a therapeutic strategy to provide the expected result, intimacy must be adequately addressed by professionals and by the rest of the members of the therapeutic community. However, the professional must inquire about the scope of the individual's rights to preserve their privacy. A part of this right is the one that refers to the confidentiality of the data of itself, which the professional and the therapeutic team must preserve (Fisher & Jaber, 2019). To avoid the problem, it is very convenient to make it clear, before starting any group or individual therapy process, all aspects that can influence both negatively and positively to achieve its effectiveness. Other ethical principles include respect for the dignity and rights of the patient, the autonomy, and the value of the patients. It is also vital to maintain high levels of competence and responsibility (both professional and scientific responsibilities) to ensure that the patient is not harmed in any way.

Nic’s DSM-5 diagnosis

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Nic’s condition would fall under the “Addictive and Substance-Related Disorders.” Addictive and substance-related disorders are those health problems caused by the acute or chronic consumption of psychoactive substances (Grant et al., 2016). DSM-5 classifies psychoactive substances into 10 classes of drugs, including alcohol, caffeine, cannabis, hallucinogens (phencyclidine and others), inhalants, opiates, sedatives/hypnotics/anxiolytics, stimulants (amphetamines, cocaine, and others), tobacco and other substances.

There are two main groups of substance-related disorders; substance use disorders (SUD) and substance-induced disorders (SID). SUD refers to an addiction to the consumption of a substance. Two of the following criteria must be met for diagnosis in 12 months: Dangerous use, social or interpersonal problems related to consumption, failure to fulfill the main roles due to consumption, withdrawal syndrome, tolerance (use of more substance or more time), repeated attempts to quit or control consumption, spending more time than the addict thought on activities related to consumption, having physical or psychological problems related to consumption, and stopping doing other activities due to consumption (Grant et al., 2016). SID includes poisoning, abstinence, and other mental disorders such as obsessive-compulsive disorder, bipolar, anxiety, and neurocognitive disorder among others.

Need for Possible Medical Detoxification

Nics need to be referred to a physician to be assessed for possible medical detoxification/stabilization because of several reasons. The goal of drug detoxification, also called toxin elimination or withdrawal treatment, is to get the patient who is addicted to a toxic substance to stop using the addictive drug as quickly and safely as possible (Hill, 2015). Nic is addicted to meth and keeps relapsing, therefore, medical detoxification will help him to stop using it quickly and minimise withdrawal effects.

Nic’s Treatment Plan

Nic should first go through a detoxification process that will consist of a medicalized treatment to help him overcome his addiction and control his withdrawal symptoms and finally eliminate the addiction. Methamphetamine detoxification requires the prescription of antipsychotic medications. The goal is to cause a calming effect and reduce distress, especially in withdrawal (Farhadian et al., 2017). The process will consist of three main steps; detoxification, de-habituation (will be done when Nic is out of hospitalization to help him live without consuming meth. De-habituation will also help in enhancing psychosocial functioning and promoting healthy habits), and finally reintegration (this step will involve consolidation of the changes in Nic and coming up with future commitment plans to avoid relapsing).

After the first step of detoxification has passed, self-help groups and behavioral therapy will be used since these methods can go a long way in helping the patient learn to control their drug compulsion and lean on other patients. Self-help groups provide emotional support to the patient since they can reduce feelings of shame and isolation that can lead to a relapse (Hill, 2015). Besides, they help the patient understand that addiction is a chronic disorder with a risk of relapse. Behavioral therapy can be applied as part of a treatment program for drug abuse. It is a form of psychotherapy in which a licensed psychologist, psychiatrist, or licensed alcohol and drug therapist will provide the patient with techniques to cope with their drug compulsion, avoid relapse, or strategies for dealing with possible relapse.

Family Involvement in Nic’s Treatment Plan

Nic’s family should be involved in the treatment plan. It is in the family that people find comfort, confidence, and motivation to be able to continue the treatment. The positive evolution of treatment for drug addicts is related to the appropriate participation of family members since the family is a system where each member is interconnected so that the change in one of the parts causes repercussions in the others (Nattala, Leung, Nagarajaiah, & Murthy, 2010). The participation of patients’ family members is therefore very crucial in the recovery process since it motivates the addict to continue with the treatment process and not to feel lonely. The family’s love and support guarantee the effectiveness of the treatment process.

References

Farhadian, M., Akbarfahimi, M., Abharian, P. H., Hosseini, S. G., & Shokri, S. (2017). Assessment of executive functions in methamphetamine-addicted individuals: Emphasis on duration of addiction and abstinence. Basic and clinical neuroscience, 8(2), 147. https://dx.doi.org/10.18869%2Fnirp.bcn.8.2.147

Fisher, C. B., & Jaber, R. (2019). Ethical Issues in Substance-Use Prevention Research. In Prevention of Substance Use (pp. 281-299). Springer, Cham. https://www.researchgate.net/deref/http%3A%2F%2Fdx.doi.org%2F10.1007%2F978-3-030-00627-3_18

Grant, B. F., Saha, T. D., Ruan, W. J., Goldstein, R. B., Chou, S. P., Jung, J., & Hasin, D. S. (2016). Epidemiology of DSM-5 drug use disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions–III. JAMA Psychiatry, 73(1), 39-47. https://doi.org/10.1001/jamapsychiatry.2015.2132

Hill, R. (2015). Evidence-based practices for treatment of methamphetamine dependency: A review. Guelph, Community Engaged Scholarship Institute. https://pdfs.semanticscholar.org/ba6a/3e9ee81f9ccb5635cef8a9586c6b5473a9eb.pdf

Nattala, P., Leung, K. S., Nagarajaiah, & Murthy, P. (2010). Family member involvement in relapse prevention improves alcohol dependence outcomes: A prospective study at an addiction treatment facility in India. Journal of studies on alcohol and drugs, 71(4), 581-587. https://doi.org/10.15288/jsad.2010.71.581

Taylor, J. (2019). Beautiful Boy. The American Journal of Psychiatry Residents’ Journal 1(3), 19. Retrieved from https://psychiatryonline.org/doi/pdf/10.1176/appi.ajp-rj.2019.150212