In the first part of this discussion, you are encouraged to think about the language used by both professionals and lay people to refer to individuals with substance use disorders.
Terms like “drunk”, \”junkie\”, \”pot head\’ and “coke head” may seem obviously derogatory. But what do you think about referring to people as “addicts” or “alcoholics”?
What do you think is the impact of labeling someone as a \”addict, alcoholic, substance-user, or abuser\” as opposed to referring to them as \”a person with a substance use disorder\”? substance use disorder essay
How might differences in language to to refer to people with substance use disorder, impact how we think about our patients?
How might these differences in language impact how patients view and think about themselves and how they participate in treatment?
Next, using what you have learned in the module lectures and in the video, please address the following questions:
Discuss the importance of having a thorough patient assessment (also called a psychosocial assessment or psychosocial history) prior to beginning substance use disorder treatment.
What are some common barriers or obstacles you might expect when attempting to complete an assessment?
What are potential strengths and drawbacks of using one or more validated screening tools as part of the assessment process? substance use disorder essay
While some prefer an open-ended interview approach, what are the advantages of a structured assessment approach?
How does the assessment of a patient connect to the level of care, interventions and counseling methods the counselor chooses?
Terminology, screening and assessment
Although referring to people as addicts and alcoholics is not derogatory, the use of these terms is still discouraged since they inadvertently stigmatize the people who have addictive behaviors since it presents the notion that they are personally culpable for the condition and deserve punishment. In fact, these terms are pejorative. As stigmatizing and pejorative terms, they affect the behavior and perceptions of medical personnel, patients, their family members and the rest of the community. Instead, the individuals with these conditions should be described using the clinical condition and test results. To be more precise, alcoholics should be referred to as persons with alcohol use disorder and addicts should be referred to as persons with substance use disorder (Kelly, Wakeman & Saitz, 2015).
As earlier indicated, labeling someone as an addict, alcoholic, substance-user or abuse stigmatizes the individual since it presents the notion that the individual is personally culpable for the condition and deserves punishment. Referring to the person as a substance abuser or individual with substance use disorder creates the perception that the individual is a victim deserving of respect and care, rather than blame and punishment (Kelly, Wakeman & Saitz, 2015).
The language used to refer to persons with substance use disorder has an impact on how we think about the patient. That is because they affect our behavior and perception. For instance, the use of derogatory and stigmatizing terms creates the notion that the individual made the informed personal choice to have the condition and should be blamed and punished. On the other hand, substance use disorder is a term that would invoke sympathy, showing that the individual should neither be blamed nor punished for having the disorder. As such, the terms used to refer to the individuals with the disorder determine whether they will be blamed or accepted by other stakeholders (Kelly, Wakeman & Saitz, 2015) substance use disorder essay.
The terminologies have an effect on how patient perceive themselves and behave. The use of derogatory and stigmatizing terms reduces the patients’ self-worth and makes them less receptive to treatment since they would consider the condition as a deserved punishment for past vices. In contrast, the use of non-derogatory and non-stigmatizing terms improve the patients’ self-worth, making them feel that they deserve treatment and care. This makes them receptive to treatment as they feel that the condition is an unfortunate incidence that can be corrected through faithfully adhering to the treatment regime (Kelly, Wakeman & Saitz, 2015).
A thorough patient assessment prior to treatment beginning is important since it serves three functions. Firstly, it determines whether the patient can withstand the stresses of the selected treatment plan or if it is necessary to adopt an alternative treatment approach. This is based on the risk assessment results. Secondly, it determines if it is necessary to modify the treatment plan based on the presented physicals, history and classification system. Thirdly, it determines if the patients require supplementary treatment based on other presenting conditions and how they would affect the treatment plan (Wheeler, 2014) substance use disorder essay.
There are five common barriers to completing an assessment. The first barrier is reliance on technology, other medical personnel and other resources such that their absence hinders the assessment. The second barrier is lack of time and interruptions that make it difficult to conduct a comprehensive assessment. The third barrier is facility/hospital culture that presents policies and standards that could hinder efforts to collect some information. The fourth barrier is lack of confidence that hinders medical personnel from conducting assessments. The final barrier is specialty area that limits medical personnel to conducting assessment in areas in which they specialize (Wheeler, 2014).
Validated screening tools used in assessment processes have some strengths and weaknesses. The strengths of these screening tools include ability to assess several areas, availability in different versions and languages, sensitivity for the targeted condition, and ease of administration. The drawbacks include interpretation complexity as patient demographics (cultural background, education and age) affect scores, inability to detect subtle effects, non-comprehensive approach that ignores potentially important information, and having a narrow scope that does not allow for non-classic cases to be assessed (Wheeler, 2014).
Structured assessment approaches offer some advantages. Firstly, they improve the relevance of the collected information, especially when they use algorithms and prompts. Secondly, they reduce the incidence of missed information. Thirdly, they improve the quality and completeness of clinical documentation. Fourthly, they improve communication between patients and medical personnel substance use disorder essay. Fifthly, they improve implementation of care. Sixthly, they act as real-time visualization tools that provide clarity to the case. Finally, they bring the patient into the discussion early thereby improving the value and quality of the collected information (Wheeler, 2014).
The assessment of a patient is linked to the level of care, intervention and counseling methods chosen. This occurs through evidence-based protocols and guidelines that improve and standardize care by employing guidelines for care that are adapted to meet the unique needs of each case. In fact, the results of the assessment act as input for personalizing the evidence-based care guidelines for each case (Wheeler, 2014). substance use disorder essay
Kelly, J., Wakeman, S. & Saitz, R. (2015). Stop talking ‘dirty’: Clinicians, language, and quality of care for the leading cause of preventable death in the United States. American Journal of Medicine, 128, 8–9.
Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company substance use disorder essay.