There is a close connection between impulsivity, compulsivity, and addiction. While addiction is defined as a process coordinating the change from an impulsive to compulsive behavior, impulsivity occurs in the early stages of addiction. A person acting impulsively experiences the pleasure of their addiction, and the compulsive aspect would take control when there is a shift causing a person to stay away from their addictions. However, the compulsive behavior would compel a person to participate in their addictions to relieve themselves from the withdrawal effects. The purpose of this paper is to show how to assess and develop a personalized treatment plan for clients with impulsivity, compulsivity, and addiction based on the decision on medications to prescribe to a client, including ethical and legal implications related to the described treatment for clients with impulsivity, compulsivity and addiction.
Introduction to the Case Study
The case in this assignment involves a 53-year-old Puerto Rican female who was administered to the clinic because of an “embarrassing problem” with alcohol addiction in her early 20s when her father passed. The client’s report on being involved in alcoholism is anonymously defined as “on and off” for the past 25 years. The patient also has difficulty in maintaining sobriety which has worsened in the last two years due to her battling with gambling addiction after a casino was opened near her home. This increased the rate of her cigarette smoking, and she is concerned about the negative effect of cigarette smoking on her health.
Decision #1
Initiate the treatment with Naltrexone (Vivitrol) 380mg injection intramuscularly through the gluteal region after every four weeks.
Reason for this Decision
Naltrexone (Vivitrol) is a common description for alcohol addiction, and it works by reducing the amount of alcohol intake by modulating opioid systems. Solli et al. (2018) ascertains that this aids in reinforcing the side effects of alcohol. FDA approved Naltrexone injection in 2006 to address the problem of compliance with oral Naltrexone. The drug is taken monthly instead of taking the daily oral dosage of Naltrexone, that is used to reduce the opportunity of patients discontinuing their medications impulsively.
Why Other Decisions Were Not Selected
Antabuse (Disulfiram) 250 mg orally daily and Campral (Acamprosate) 666 mg orally three times a day are not ideal for this client. These medications are always prescribed for clients who would want to continue abstaining from alcohol. A client taking Antabuse and drinking alcohol may experience adverse side effects such as alcohol toxicity (Mason & Heyser, 2021). This makes this drug not ideal for the client at this time. On the other hand, Campral is not fit for the client because of her weight. She weighs 122lbs which is less than 132lbs. Such patients should take four tablets a day instead of six.
What I Was Hoping to Achieve by Making This Decision
By administering this medication, I hope to decrease the alcohol craving in the patient without letting her go through severe side effects and any future relapses. Naltrexone injection can start working within a few days, but its optimal effect would not be seen until the end of one or two weeks. After four weeks, the client reported to the clinic that she felt wonderful and had not craved alcohol or been in the casino as often since she received her first Naltrexone injection. However, she is concerned that her smoking habit is still persistent and also fights the problem of anxiety and goes to the casino.
Ethical Considerations Impact on Treatment Plan and Communication
Beneficence and patient right to autonomy influence the treatment plan for the patient. I had to select a medication associated with the best outcomes and consequently prescribed Naltrexone injection because there is evidence supporting its efficacy in treating addiction. Besides, I had to seek consent from the patient to initiate treatment.
Decision #2
Refer the client to a counselor to address the gambling issue.
Reason for this Decision
Despite the client responding positively to the given treatment, her gambling addiction is still persistent and needs to be addressed. Therefore, referring her to a counselor is the correct stage to take for the client. Fighting gambling addiction is not easy, but it can be achieved with the help of support groups and treatment programs. The counselor helps the client to identify the underlying cause of pathogenic gambling (Pettorruso et al., 2020). One cause of gambling is living in an environment where gambling is widely practiced and accepted. Such environm
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