Substance Use Disorder After Injury

Introduction

Accidents and minor injuries are common for people in sports, and taking pain killers once in a while helps them manage pain. Hector, a 42-year-old man who has a previous history of sports injuries, gets involved in an accident where his knee was shattered in the process. The doctor caring for his injury prescribed codeine as a pain killer to relieve his pain. Long after the pains stopped, his cravings for codeine increased, and since there was no doctor to prescribe the medication, he opted to buy it from dealers. Hector became codeine dependent and spent most of his time and resources on the drug; consequently, he could no longer concentrate on his work and eventually lost it.

Codeine Description

Codeine falls under the class of opioids and is used as a painkiller for short-term use and must be under a doctor’s prescription. It is a pain relief drug that works on the Central Nervous System as a depressant and alters how the brain responds to pain (McMillan, 2018). The depression effects of the drug lower the brain’s activity, especially the part that controls coughing and serves as a cough depressant. Codeine is highly addictive when taken for a long time or not properly prescribed. Medical practitioners have described the drug as a weak and inaccurate painkiller since it metabolizes into morphine when in the body.

When the drug is induced into the body, it increases tolerance to pain and reduces any form of discomfort. The drug further leads to sedation, drowsiness, and respiratory depression, making people withdraw in search of the drug. Hector became codeine dependent after using it outside the prescription, and his cravings for the drug increased because of the comfort it gives a user. Codeine causes vasodilation in the blood vessels and consequently lowers blood pressure. Seizures, stomach cramps, and nausea may also result from codeine use (Peechakara & Gupta, 2018). In the long term, the drug induces memory impairment, which makes a person unable to perform daily life activities, and most people use their jobs courtesy of the memory loss caused by the drug. Anxiety, depression, and constipation are other results of drug use.

Codeine further affects the behaviours and psychological well-being of a person. Withdrawal is one of the most prevalent behavioural changes among codeine users because the rising craving for the drug makes a person lose interest in all daily life activities (Peechakara & Gupta, 2018). The overwhelming desire to obtain the substance causes a person to withdraw from others and focus on obtaining the drug. The patient spends most of his time thinking about where he can get the drug, and if they cannot get it from a formal prescribing doctor, the users are likely to engage street dealers to obtain the drug. Since Hector became drug dependent, he could no longer concentrate and lost his job in the discourse. Behavioural changes expected from people suffering from codeine addiction include stealing money from friends and relatives to obtain the drug. Whenever codeine is unavailable, the patient opts for other opioids to service their craving. A codeine addict experiences insomnia, a prerequisite for other mental health illnesses.

Criteria for Substance Use Disorder

DSM-5 is an assessment manual that diagnoses mental illness as the first step to propose a treatment plan depending on the severity of the mental disorder. Substance Use Disorder (SUD) is a mental health disorder that makes a person unable to control their desire and use the drugs. For any situation to be qualified as a SUD, it must be congruent to the four DSM-5 categories, impaired control, risky use, social problem, and physical dependence (Verplaetse et al., 2018). Hector’s inability to control his craving for the drug qualifies it as a substance use disorder. He lost control the time he went against the doctor’s prescription and started obtaining the drug from the roadside and strict vendors. Although he wanted to stop taking the drug, he could not, risking his life.

Hector experiences the effects of risky use by losing interest in the important activities in life, including work and social life. Risky use is the consumption of drugs without prescription, conscious that it may negatively impact the person (Verplaetse et al., 2018). Hector is aware that consuming codeine without a doctor’s prescription is risky, and buying it from unlicensed dealers makes it even more dangerous. Still, he ignores all the safety protocols and consumes them to satisfy his craving. The case study further meets the criteria to be a substance use disorder because it has a social effect on Hector since he could not perform his expected roles at work which made him unfit for the job, and he lost it in the long run. As Hector’s work suffered, his social relationship with his family also suffered as he could no longer get time for them as all his attention was fixed on the craving and how to satisfy them. Physical dependence is further observed because Hector could not perform his normal functions without using the drug. His body was used to the drug that it only found comfort when he used it. Hector’s case study covers all the four criteria for SUD and therefore qualifies it to be an addiction case that can be treated.

Medical Treatment for the Substance Use Disorder

The medical treatment administered to drug addicts varies from one person to another based on the severity of the drug usage. It is, however, judicious to note that the first step to SUD treatment is the acknowledgment and acceptance by the addict like Hector and seeking help. A medical doctor can conduct a comprehensive exam to determine the composition of codeine in the bloodstream and determine the personalized treatment plan to reduce drug dependency. Hector’s SUD can be treated using detoxification and behavioural therapy to eradicate the craving and withdrawal symptoms. Detoxification is a medication that makes Hector stop using codeine. Detoxification is achieved by using (Food and Drug Administration) FDA-approved medication such as methadone, naltrexone, and buprenorphine (Nielsen et al., 2018). The drugs serve as the alternatives to codeine, and Hector will no longer crave it. Further, behavioural therapy is critical in ensuring that Hector abandons all the behaviours that may lead to self-destruction and unhealthy behaviours that are likely to jeopardize his wealth and well-being.

Conclussion

Codeine is a popular drug used to treat pain, diarrhea, and coughing, which must be prescribed by a doctor and used for a shorter time. Hector underwent codeine treatment to ease the pain when he was involved in an accident but unfortunately became addicted. The case study offers a Substance Use Disorder that can be treated using detoxification and behavioural therapy. Clinical awareness is key to ensuring people use drugs only under the strict prescription of a qualified healthcare practitioner.

References

McMillan, D. (2018). Brain CYP2D metabolism of opioids impacts brain levels, analgesia, and tolerance. Doctoral dissertation, University of Toronto, Canada.

Nielsen, S., MacDonald, T., & Johnson, J. L. (2018). Identifying and treating codeine dependence: A systematic review. Medical Journal of Australia, 208(10), 451-461.

Peechakara, B. V., & Gupta, M. (2018). Codeine.

Verplaetse, T. L., Moore, K. E., Pittman, B. P., Roberts, W., Oberleitner, L. M., Smith, P. H., & McKee, S. A. (2018). The intersection of stress and gender associated with transitions in past year DSM-5 substance use disorder diagnoses in the United States. Chronic Stress, 2, 2470547017752637.