AMS Program Case Study

Xavier then reported, the applicant recovery is up and down and the reason the patient was transferred and admitted to the Norwich location was due to an altercation as the Hartford Dispensary has zero tolerance for physical violence. Since May of of this year, the applicant's UDS results are negative. Last positive result was in April for cocaine, according to the counselor. Please note, during the applicant intake, he was asked about other illicit drugs and only confirmed for use of heroin and THC, not the cocaine. The applicant's current dose at the Hartford Dispensary is 105mgs as he is being detoxed daily. His highest dose was at 145 mgs before his detoxification. The physical altercation was the applicant's first behavioral incident at the clinic. He was also on a 90 Probation for his illicit use and it would have expired in August, but due to the recent incident, he was removed from the clinic, not discharged, but transferred as mentioned before. Counselor Xavier only concern of the applicant is maintaining his

2. The patient was provided with weekly sessions, random UDS testing, group sessions if needed, and any other case management the patient needed. The patient came to the clinic in need of treatment for his opioid dependence and was compliant with his treatment.

will schedule an appointment to discuss and create a budget plan. Patient is currently free from all illicit drugs, which has helped her Adderall medication to be more beneficial. Primary Counselor will encourage Pt. to follow through with all mental health appointments. Counselor will prompt Pt. to develop a positive self-image. Pt. has denied having any auditory or visual hallucinations during the last quarter as evidenced by group and individual session notes. Pt. has had some setback in achieving her goals of decreasing her family conflicts and resolving intimate relationship issues. Counselor will encourage Pt. to attend the AMS parenting group and share her expectations regarding having a more functional family unit. During the next quarter therapy sessions, Counselor will utilize role-playing, role reversal, modeling, and behavioral rehearsal to assist Pt. in order to develop positive ways to resolve conflict with ex-husband. Pt.’s current treatment plan goals focus on opiate use disorder, financial, mental health services and parent-child relational problems. During the upcoming quarter, current goals will continue to be

Met with the patient as directed by the Clinical Director. According to the patient, he requested for a dose decrease of 1mgs per day until he reaches 0mgs. Based on the patient's order, he is indeed decreasing his methadone of 1mgs; however, the order stated that it will stop at 53mgs, not 0mgs. The patient informed this writer about a discussion he had with his assigned counselor Cherron about the importance of this due to the need to get off on the methadone as he wants to obtain his CDL but cannot do so if he is prescribed with methadone. This writer reviewed the patient's record and there are no AMA taper signed and no medical consultation documented. This writer then addresses this matter with the clinic's medical doctor, who was told

A-Based on the writer’s assessment, the client is motivated to change for the better. He test negative for one UA on 11/17/2015 and positive during his enrollment at the clinic for opioids. He continues to say throughout the session about wanting to his reduce his use of methadone. It appears that the client is in a maintenance stage. There was no evidence of SI/HI. All components of MSE were WNL functioning.

Counselor met with Pt. for a scheduled individual session. Counselor and Pt. discussed his progress, current recovery progress, any personal concern and his treatment plan update. Pt. reported that he has no serious mental health issue and reported not experiencing suicidal thoughts. Pt is financially stable and he is taking his methadone as prescribed by AMS Doctor. Pt. explained that his current prescribed dosage of methadone isn’t working because around 3 pm he gets tired, start sweating and experiencing hot flashes and cravings. Counselor helped Pt. to discuss and complete an AMS Dose Evaluation form. Counselor asked him, “How do you currently see yourself and are you happy with what you see?” Pt. was expected to answer the question and

Pt.'s urine drug screen results at the time of discharge reflect a pattern of heavy opiates use since his admission to the program. Pt. is heading down an unhealthy path likely to lead to legal issues and serious emotional and physical complications due to sudden discontinuation of treatment services. At the present time Patient is aware of some pros and cons of substance abuse but feels ambivalent about change unless he has entered another substance abuse program. Pt. also failed to deal with the stress that occurs due to his financial difficulties. Pt. discontinued attending without warning or

Molly meets the criteria for severe opioid use disorder as evidenced by her recurrent use of opioids, impaired control over substance intake, continued use despite negative consequences, and unsuccessful attempts to cut down or quit. Inpatient detoxification and stabilization is recommended at this time to address Molly's physical dependence on opioids through medically supervised detoxification to manage withdrawal symptoms, stabilize her physiological functioning, and ensure her physical safety during treatment. Molly will benefit from Motivational Interviewing (MI) to increase her intrinsic motivation, enhance her readiness to change, and foster a sense of self-efficacy in her recovery journey. Due to strained relationships with loved ones, family therapy is encouraged to repair

The patient recognizes his substance abuse is interfering with his life, but needs assistance with addressing the opioid dependence referring to alternatives for his trigger points. During the course of the session, there was no evidence of

¨ More than a quarter of a million Americans are enrolled in methadone clinics, where they participate in “methadone replacement” or “methadone maintenance” to treat narcotic addictions to heroin or morphine, or prescription painkillers like oxycodone, hydrocodone, OxyContin or Vicodin.¨ (Novus Detox, 2016) Clinics that treat opioid addiction use several combinations other than methadone to be effective. In addition to daily methadone treatments, there are also random drug test to make sure the individual is complying with the program. There is also individual and group counseling that provides education and support with each being customized with goals set forth by the patient. Some addiction require patients struggling to seek professional help with a psychiatrist and/or speciality

“In 1949, Isbell and Vogel, working at the U.S. Public Health Hospital in Lexington, Kentucky, showed methadone to be the most effective medication for withdrawing addicts from heroin (Joseph, Stancliff, & Landgord, 2000, p. 347). Further studies revealed that administering methadone to an addict for seven to ten days had a relapse rate of more than 90% when treatment ceased. “By 1998, the number of methadone patients in the United States had increased from the original six research patients in 1964 to about 44,000 patients in New York Stated and 179,000 patients worldwide” (Joseph, Stancliff, & Landgord, 2000, p. 347). The number of individuals enrolled in MMT continues to increase as the methadone clinics and the overall effectiveness of MMT gains

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

In 1991, the Opiate Treatment Index (OTI) was developed to measure the effectiveness of treatments, looking to not only measure abstinence of opioid use but to identify treatment outcomes that would lead to sustainable recovery (Darke, Ward, Hall, Heather and Wodak, 1991). The index measures “drug use, HIV risk taking behaviors, social functioning, criminality, health status, and psychological functioning.” In 2001, an amendment was added to the Controlled Substance Act that required US physicians who prescribe buprenorphine, to provide support treatment or referral to behavioral treatment (SAMHSA, 2004).

Everyday more and more treatment options and medications are being used to help to combat the world of drug abuse and addiction. According to the CDC about 980,000 people in the United States are abusing some form of opiates, weather it is pills or heroin. One of the newer trends of treatment that is now being used and growing rapidly is Medical Assisted Treatment (MEDICAL ASSISTED TREATMENT). As with any treatment or medication therapy there are the medical benefits and also the medical downsides. Medical Assisted Treatment was intended to help prevent people from continuing their drug abuse, but is now not only helping people but is also turning into an abused drug itself. ‘

The participant is a 49 year old African American male who began using substances at the age of 13. He was diagnosed with severe alcohol, cocaine, and opioid use. The participant has been incarcerated over the past 32 years. He was recently paroled after completing eight years of a sixteen year sentence in the Illinois Department of Corrections for burglary and theft. The participant is on medications to treat HIV/AIDS and has been diagnosed with Major Depressive Disorder. He was referred to Healthcare Alternative Systems residential program through TASC as a condition of his probation.