Of the substance disorders, alcohol-related disorders are the most prevalent even though only a small percentage of individuals actually receive help. Recidivism in the substance treatment world is also very high. As research into treatment has developed, more and more evidence shows that genes for alcohol-metabolizing enzymes can vary by genetic inheritance. Women have been identified as particularly vulnerable to the impacts of alcohol. Native Americans, Asians, and some Hispanic and Celtic cultures also have increased vulnerability to alcohol misuse.

QUESTION

Of the substance disorders, alcohol-related disorders are the most prevalent even though only a small percentage of individuals actually receive help. Recidivism in the substance treatment world is also very high. As research into treatment has developed, more and more evidence shows that genes for alcohol-metabolizing enzymes can vary by genetic inheritance. Women have been identified as particularly vulnerable to the impacts of alcohol. Native Americans, Asians, and some Hispanic and Celtic cultures also have increased vulnerability to alcohol misuse.
Even with these developments, treatment continues to spark debate. For many years, the substance use field itself has disagreed with mental health experts as to what treatments are the most effective for substance use disorders and how to improve outcomes. The debate is often over medication-assisted treatment (MAT) versus abstinence-based treatment (ABT). Recently the American Psychiatric Association has issued guidelines to help clinicians consider integrated solutions for those suffering with these disorders. In this Discussion, you consider your treatment plan for an individual with a substance use disorder.
To prepare: Read the case provided by your instructor for this week’s Discussion and the materials for the week. Then assume that you are meeting with the client as the social worker who recorded this case.

NOTE THERE MAY BE MORE THAN ONE DIAGNOSIS. PLEASE MAKE SURE THAT THE WRITER READ THE INSTRUCTIONS CAREFULLY AND WRITE THE DIAGNOSIS LIKE THE ATTACHED EXAMPLE.

MAKE SURE THAT THE WRITER COVERS EVERY POINT

ASSIGNMENT:

1. Post a 500-word response in which you address the following:

2. Assume that you are the social worker meeting with Brandon and you recorded this case.

3. provide the full DSM-5 diagnosis for Brandon. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may need clinical attention). Make sure you describe all of the DSM-5 criteria Brandon meets for the diagnosis you identified.
Identify and describe the assessment(s) you would use to validate his diagnosis, clarify missing information, or track his progress.

4. Clearly describe how you would explain the diagnosis to Brandon.

5. Explain how you would engage his in treatment
Identifying potential cultural considerations related to substance use.

6.Describe your initial recommendations for his treatment and explain why you would recommend MAT or ABT.

7. Identify specific resources to which you would refer his and explain for each resource why you would recommend it based on his diagnosis and other identity characteristics (e.g., age, sex, gender, sexual orientation, class, ethnicity, religion, etc.).

8. Thoroughly support each of your explanations with social work concepts, theory, and principles from the assigned learning materials and from the scholarly articles you selected.

9. Document your references and cite them throughout your post following APA guidelines.

10. Initial post provides an accurate diagnosis for the case. Diagnosis is correctly written. Post accurately identifies diagnostic criteria used and does an exemplary job connecting diagnostic criteria to specific examples in the case study.

11. Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas. Posts demonstrate exemplary critical thought.

12. Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate-level writing style

ANSWER

As the social worker meeting with Brandon, I have carefully reviewed his case and considered the information provided.

 Based on the symptoms and criteria presented, I would provide the following DSM-5 diagnosis for Brandon:

 Alcohol Use Disorder (Alcohol Dependence), Severe, ICD-10-CM code F10.20, with specifiers:

   – Severity: Severe (Brandon exhibits multiple symptoms that indicate a severe level of impairment and dysfunction related to alcohol use).

   – Z codes: Z55.1 (Exposure to alcohol in the womb), Z56.5 (Unemployment), Z63.0 (Relationship distress with spouse or partner), Z63.8 (Other specified problems related to primary support group).

Brandon meets the criteria for Alcohol Use Disorder based on the DSM-5. He exhibits the following symptoms

Impaired control: Brandon has been unsuccessful in his attempts to cut down or control his alcohol consumption. He continues to drink larger amounts and for longer periods than intended.

Social impairment: Brandon’s alcohol use has negatively affected his relationships, as indicated by his deteriorating marriage and the lack of social support (Moon et al., 2018).

Risky use: Brandon engages in risky behaviors while intoxicated, such as driving under the influence. He also experiences blackouts and memory lapses.

Pharmacological criteria: Brandon experiences withdrawal symptoms when he tries to quit or cut back on alcohol. This is evident from his anxiety, irritability, and tremors when he stops drinking.

To validate Brandon’s diagnosis and track his progress, I would use the following assessments

AUDIT (Alcohol Use Disorders Identification Test): This screening tool would help assess the severity of Brandon’s alcohol use and provide a baseline for tracking changes over time.

CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol): This assessment would be valuable during the detoxification process to monitor and manage Brandon’s withdrawal symptoms.

To explain the diagnosis to Brandon, I would use a person-centered and empathetic approach. I would emphasize that Alcohol Use Disorder is a medical condition and not a personal failing or weakness. I would explain that the diagnosis is based on the presence of specific symptoms and impairment in various areas of his life, such as relationships, work, and physical and mental well-being. I would also highlight that treatment is available and can lead to improved quality of life and overall functioning.

To engage Brandon in treatment, I would emphasize the importance of a collaborative approach. I would encourage him to share his goals, concerns, and preferences regarding treatment. It would be crucial to create a safe and non-judgmental environment where he feels comfortable discussing his struggles and aspirations.

Considering potential cultural considerations related to substance use, it is important to recognize that different cultures may have unique attitudes, beliefs, and practices regarding alcohol. For example, Native Americans, Asians, and some Hispanic and Celtic cultures have shown increased vulnerability to alcohol misuse (Sudhinaraset, 2016). Therefore, it would be important to incorporate culturally sensitive approaches that respect and address Brandon’s cultural background and beliefs.

Based on the available research and evidence, my initial recommendation for treatment would be Medication-Assisted Treatment (MAT). MAT combines medications, such as naltrexone or acamprosate, with behavioral therapies to address Alcohol Use Disorder. MAT has been shown to reduce alcohol cravings, promote abstinence, and improve treatment outcomes (Moon et al., 2018b). Given the severity of Brandon’s alcohol dependence and the potential for withdrawal symptoms, medication support could be beneficial in managing his condition.

In terms of specific resources, I would refer Brandon to the following:

Outpatient Treatment Program: This program would provide comprehensive treatment, including individual therapy, group counseling, and psychoeducation about addiction. It would offer a supportive environment where Brandon can learn coping skills and receive ongoing support (Lehman et al., 2017).

Alcoholics Anonymous (AA): AA is a self-help group that follows an abstinence-based approach. It provides a community of individuals in recovery and emphasizes peer support. Given Brandon’s preference for an abstinence-based approach, AA could be a valuable resource for him.

Marriage and Family Therapy: Given the relationship distress with his spouse, I would recommend couples therapy or marital counseling to address the interpersonal challenges they are facing. This resource could support both Brandon and his spouse in rebuilding trust, improving communication, and enhancing their relationship.

These recommendations align with social work principles and concepts such as person-centered practice, cultural competence, and the bio-psycho-social-spiritual perspective. By considering Brandon’s individual needs, cultural background, and the available evidence-based treatments, these resources offer a holistic approach to addressing his Alcohol Use Disorder and related challenges.

References

Lehman, B. A., David, D. M., & Gruber, J. (2017). Rethinking the biopsychosocial model of health: Understanding health as a dynamic system. Social and Personality Psychology Compass, 11(8), e12328. https://doi.org/10.1111/spc3.12328 

Moon, T. J., Mathias, C. W., Mullen, J., Karns-Wright, T. E., Hill-Kapturczak, N., Roache, J. D., & Dougherty, D. M. (2018). The Role of Social Support in Motivating Reductions in Alcohol Use: A Test of Three Models of Social Support in Alcohol-Impaired Drivers. Alcoholism: Clinical and Experimental Research, 43(1), 123–134. https://doi.org/10.1111/acer.13911 

Sudhinaraset, M. (2016). Social and Cultural Contexts of Alcohol Use: Influences in a Social–Ecological Framework. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872611/