Assessment and Diagnosis
Assessment and Diagnosis
Screening is the process of identifying if a patient has a substance use disorder (Dziegielewski, 2015). Screening is done using the recommended medical tests approved by health regulators. For substance use disorder screening to be performed, there must be determining factors that enable the screening process to be carried out (Dziegielewski, 2015). Some of the factors may include a prevalence of substance abuse within the population, visible signs, and symptoms, which prompt the screening process, the screening methods availability, and reliability of the screening tests must be considered (Dziegielewski, 2015).
The healthcare practitioner in the implementation process of treatment strategies carries out screening to ascertain substance use disorders or the risk of patients in developing drug related problems, which will enable a better decision-making process (Dziegielewski, 2015). Assessment of patients with substance use disorders is aimed to provide more knowledge to the healthcare practitioners, which helps in the screening process, treatment process, and providing support to the patients (Dziegielewski, 2015). The treatment plan involves strategies and measures to address the substance use disorder, which is determined based on factors that may include the severity of the condition, the age of the patient, and environmental factors (Dziegielewski, 2015).
Crisis management is important especially when dealing with clients suffering from substance use disorders as this medical condition causes distress to the patients, which may lead to a negative outcome or relapse which will negatively impact the patients who are on treatment plans (Mignon, 2015). Patients suffering from substance use disorders are at a high risk of a relapse and healthcare practitioners must be prepared to address any issues that may lead the client back to substance abuse (Mignon, 2015).
Healthcare practitioners should have back up plans and strategies to implement if one of their patient suffers a crisis as during this time the patients have low ability to have a control over their issues and support from healthcare practitioners can largely impact the patients in going back to their normal lives and back to the treatment processes (Mignon, 2015). The treatment process may also be overwhelming for the patient and crisis management can be able to address any problems quickly before they lead to a more serious health issue (Mignon, 2015).
Substance use disorders must be effectively assessed to enable better planning of the treatment process (Schwitzer & Rubin, 2014). The assessment process of identifying addictive disorders involves performing an assessment depending on the objectives of the healthcare practitioner (Schwitzer & Rubin, 2014). This can involve interviews on the patients to determine certain information about addictive disorders and to determine the medical procedures to undertake. Individuals with addictive disorders must also display signs and symptoms indicating a drug addiction problem or a screening test must have provided positive results (Schwitzer & Rubin, 2014).
An effective assessment can provide vital information such as the duration the patient has engaged in the drug problem issue and other health problems that have resulted from the drug addictive problem (Schwitzer & Rubin, 2014). This information also helps a healthcare practitioner in determining if the patient has an addictive drug problem. An in-depth assessment may follow or immediate intervention to relieve any pressing health issues. A treatment plan may also be implemented with strategies to prevent a relapse (Schwitzer & Rubin, 2014).
Considerations for choosing an appropriate assessment tool involve the objectives of the assessment, which may include the severity of the condition or what other related health issues may be present for a particular condition (Lowinson, Ruiz, & Millman, 2015). Other considerations may involve the nature of the patient which may include the age of the client, the gender of the patient, and their physical well-being (Lowinson, Ruiz, & Millman, 2015). The treatment options available may also determine the assessment tools to be used as medications may be based on the results of a particular assessment (Lowinson, Ruiz, & Millman, 2015).
Culture is also a consideration regarding choosing an assessment tool. Some questionnaires may not be available to certain languages, which may make the healthcare practitioner to choose a different type of an assessment tool (Lowinson, Ruiz, & Millman, 2015). Some clients may also find certain assessment tools threatening or intrusive to their personal lives, which may lead to misleading information. This may be common for women being assessed by male practitioners (Lowinson, Ruiz, & Millman, 2015).
General Overview of Criteria
The DSM refers to the Diagnostic and Statistical Manual of Mental Disorders and has standardized names, signs and symptoms, and diagnostic features of different mental illnesses and substance use disorders based on clinical research (Dziegielewski, 2015). The DSM categorizes substance use disorders depending on the different classes of drugs, which may include caffeine, bhang, alcohol, sedatives among others. The DSM categorizes substance related disorders into two, which are substance use disorders, and substance induced disorders (Dziegielewski, 2015). Substance use disorders are symptoms related to the use of a substance with prolonged use even after the substance has resulted in negative health effects where else substance induced disorders are symptoms related to medical conditions directly connected to substance use and may include withdrawal or intoxication (Dziegielewski, 2015).
A minimum of 2 to 3 criteria must be present to determine a substance use disorder (Dziegielewski, 2015). Some of the criteria for determining substance use disorder include using a substance in large quantities than the required amount, the desire to quit but not able to and strong cravings for the substance (Dziegielewski, 2015). Negative effects from the use of the substance, which can involve antisocial behaviors, or in ability to carry out normal activities, and negative side effects when the usage is stopped suddenly are also criteria to determine a substance use disorder (Dziegielewski, 2015).
Though the DSM diagnostic tool is important in detecting substance use disorders, a counselor must not solely rely on the diagnostic criteria listed in the DSM for treatment planning as it can sometimes give a misdiagnosis of a health issue (Mignon, 2015). Healthcare practitioner’s judgments may also differ requiring an in-depth assessment. The DSM diagnostic tool does not have the capability to determine mild cases and the healthcare practitioner must apply his/her knowledge to detect any arising issue (Mignon, 2015).
Many researchers argue on the complexity of the human behavior criticizing the DSM diagnostic tool in detecting mental and substance use disorders (Mignon, 2015). This increases the chances of a misdiagnosis due to a difference in behavioral symptoms. For an effective treatment plan, the healthcare practitioner should incorporate other tools and skills in addition to the DSM diagnostic tool for proper diagnosis and treatment plans (Mignon, 2015). The knowledge and skills acquired during education and training cannot be substituted by any tool and professional judgments must apply in the treatment of clients with substance use disorders (Mignon, 2015).
Commonly used substance use disorder assessment tools include interviews and questionnaires, which help the healthcare practitioner, have a clear picture about a client’s condition (Lowinson, Ruiz, & Millman, 2015). An assessment interview helps in creating a good relationship between the counselor and the client. The interview may also involve screening tests and screening test results, which can be analyzed during this assessment (Lowinson, Ruiz, & Millman, 2015). The Alcohol Use Disorders Identification Test (AUDIT) is an assessment tool used to identify people with alcohol problems and those at risk of developing alcohol related issues (Lowinson, Ruiz, & Millman, 2015). The test is composed of ten questions to determine a diagnosis. The World Health Organization developed this test and questions may involve the number of times a client engages in drinking alcohol, the number of drinks, and any feelings of guilt after indulging in alcohol (Lowinson, Ruiz, & Millman, 2015).
Another assessment tool for substance use disorders include the Addiction Severity Index (ASI), which is administered in the form of interview to help in gathering information about a client. This tool is highly reliable and can be used across different localities and races (Lowinson, Ruiz, & Millman, 2015). The Drinker Inventory of Consequences (DrinC) is also an assessment tool, which involves a true or false questionnaire and determines the negative effects of alcohol abuse based on five perspectives, which are physical, social, impulse control, intrapersonal, and interpersonal perspectives (Lowinson, Ruiz, & Millman, 2015). The instrument is also designed for different genders where there is a section for men and a women section to determine their health issues affecting either gender since the results may be different between the different genders (Lowinson, Ruiz, & Millman, 2015).
Dziegielewski, S. F. (2015). DSM-5 in action. Hoboken, NJ: John Wiley & Sons.
Lowinson, J. H., Ruiz, P., & Millman, R. B. (2015). Substance Abuse: A Comprehensive Textbook. Philadelphia: Wolters Kluwer.
Mignon, S. I. (2015). Substance abuse treatment: Options, challenges, and effectiveness. New York, Springer Publishing Company.
Schwitzer, A. M., & Rubin, L. C. (2014). Diagnosis and Treatment Planning Skills: A Popular Culture Casebook Approach. Thousand Oaks: SAGE Publications, Inc.