What tools or resources could aid in diagnosing substance abuse disorders? How does the assessment differ between adults and adolescents? COLLAPSE

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A wide variety of substances may be abused and include alcohol, tobacco, THC, cocaine and heroin to name a few. Describe the similarities and differences with assessment of an individual among the different substances that can be potentially abused. What tools or resources could aid in diagnosing substance abuse disorders? How does the assessment differ between adults and adolescents?
COLLAPSE

A wide variety of substances may be abused and include alcohol, tobacco, THC, cocaine and heroin to name a few. Describe the similarities and differences with assessment of an individual among the different substances that can be potentially abused. What tools or resources could aid in diagnosing substance abuse disorders? How does the assessment differ between adults and adolescents?

Ans: The substance abuse is defined as use of Alcohol or recreational drugs for the purpose of intoxication. When a person uses prescription drugs beyond their intended use, it is considered as abuse (Warner, 2020).

Similarity in assessment: A thorough patient’s interview by psychiatrist or psych nurse practitioner or psychologist is first step in assessing an individual with substance abuse (Catlat, 2017). All screening questionnaire are based on substance abuse in last 12 months period. TAPS screening tool can screen most of substance use disorders.

The National Institute on Drug Abuse (NIDA) has formulated a new online screening tool that can help providers uncover patients’ substance use. It is scientifically validated. The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool was developed within the clinical trials network. It consists of a comprehensive screening component and a brief assessment for those who screen positive. Unlike other screening tools, it combines screening and brief assessment for multiple substances. The TAPS Tool may either be self-administered or an interview by a healthcare provider. The TAPS Tool has two components. The first component (TAPS­1) is a four-item screen for tobacco, alcohol, illicit drugs, and the non-medical use of prescription drugs. If an individual screens positive on TAPS­1 (i.e., gives a response other than “never”), the tool proceeds to the second component (TAPS­2), which consists of brief substance specific assessment questions through which the patient is assigned a risk level for that substance. Risk levels range in severity from “problem use” to substance use disorder (Brooks, 2018).

The questions in TAPS 1:

  1. In the past 12 months, how often have you used tobacco or any other nicotine delivery product (i.e., e-cigarette, vaping or chewing tobacco)?
  2. In the past 12 months, how often have you had 5 or more drinks (men) / 4 or more drinks (women) containing alcohol in one day?
  3. In the past 12 months, how often have you used any prescription medications just for the feeling, more than prescribed or that were not prescribed for you?
  4. In the past 12 months, how often have you use any drugs including marijuana, cocaine or crack, heroin, methamphetamine (crystal meth), hallucinogens, ecstasy/MDMA? (Brooks, 2018)

Differences:  There are different DSM-5 diagnostic criteria for each substance use disorders (APA, 2013). There are a set of questioners with a little different question for each substance use in screening tool. The CASE screening questionnaire are for Alcohol abuse (Carlat, 2017).

Difference in assessing Adolescents:

In case of an adolescent patient, the care provider should interview adolescent and family member separately. The adolescents are great minimizers, and deniers. The care provider should keep enough time for the interview. The adolescent does not want to talk about his or her problem spontaneously, and care provide should allow enough time for the adolescent to answer. First the provider should create a rapport with the patient. The Adolescent should know that all information will be confidential (Carlat,2017).

                                                                Reference

American Psychiatric Association (2013). Diagnostic and statistical Manual of Mental Disorders: DSM-5 (5th ed.), Arlington, VA: APA

Brooks, M. (2018). NIDA Releases New Online Screening Tool for Substance Abuse.

https://www.medscape.com/viewarticle/898775

Carlat, D. J. (2017). The Psychiatric Interview (4th ed.), New York: Wolters Kluwer.

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