781 SN Final Project Antonio
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Syracuse University *
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781
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Nursing
Date
Apr 29, 2024
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Shannon Newberry Final Project
Final Project
SN
Syracuse University
SWK 781: Alcohol and Other Drugs in Social Work Practice
Background Information:
Antonio is an employed, 27-year-old, African American male who identifies as such. Antonio is a divorced father of a six-year-old daughter, he was married four years before the
2
Shannon Newberry Final Project
relationship ended in divorce due to alcohol and drug use. Antonio lost his weekend visits with his daughter when his ex-wife had concerns regarding his alcohol and drug use while his daughter was with him. Antonio was sexually abused at the age of 11 by his maternal uncle. He is the youngest child, his two sisters live in other states, he has little contact with them. Antonio’s parents divorced at the age of 13, at age 17 his mother remarried, but he doesn’t have a
good relationship with his stepfather. Antonio reports his stepfather was emotionally and physically abusive to both him and his mother, his mother and stepfather have a drinking addiction. Antonio had a good relationship with his father who died from prostate cancer three years ago; Antonio is a cancer survivor who has been in remission for several years. Ethical considerations
: Antonio would like assistance to regain unsupervised visits with his daughter which is why he is interested in outpatient treatment. Antonio also has a pistol which he keeps at his home. Cultural/ethnic/other diversity considerations
: Antonio and his family may have a cultural attitude toward drinking and because alcohol use disorder has a high chance to be hereditary, with around 50% of the variance of risk explained by genetic factors and because Antonio has close relatives with alcohol use disorder, he is at a higher risk of developing it AUD (Casey & Jones, 2021).
Client strengths and areas of deficiency
:
3
Shannon Newberry Final Project
Antonio strengths are his motivation to do well at his place of employment. Antonio is a cancer survivor. He has made progress by abstaining from some areas of drug use. Antonio is also very interested and motivated in doing well to be able to see his daughter.
Areas of concern with Antonio are his resistance and uncertainty regarding engaging in and participating in treatment. Safety concerns are Antonio’s history of suicidal ideations and past suicidal behaviors. Another area of possible concern is his access to a firearm as well as his past suicidal behaviors. Diagnostic Impression Antonio has a family history of alcohol abuse. He first reported drinking when he was 13 years old and relayed that his mother and stepfather now abuse alcohol. Antonio reports that while married he began using alcohol and heroin with greater frequency which is what lead to his
divorce. He also reports he lost visitation with his daughter when his ex-wife reported that he had left their daughter alone overnight on a Saturday and didn’t return until Sunday afternoon. When asked about the incident, Antonio reported that he didn’t have any memory of the incident and refused to discuss it further. Antonio indicated he doesn’t feel he has a problem with his drinking even though other people might think he does. When Antonio was pressed for more information about his drinking, he evaded the conversion. He does admit to increasing patterns of tolerance and has experienced considerable withdrawal symptoms in the past. Antonio states he uses alcohol to help him sleep and reported his only concern about his drinking was his ability
to take his current medications when he was drinking. When asked about his previous drug use, he said he started smoking marijuana around the age of 13, the same time he started drinking. He said, “weed isn’t really a hard-core drug,
4
Shannon Newberry Final Project
everybody is out there smoking so I don’t see any problem with it” When asked how much and with what frequency he smokes marijuana he reports he smokes every day. He reported using heroin two to three times a week up-until he was hospitalized but states he has not used heroin since his hospitalization. Substance abuse is the use of a harmful substance for mood-altering purposes. "Substances" can include alcohol and other drugs as well as some substances that are not drugs at
all. "Abuse" results from using a substance in a way not intended for (McLellan A. T. 2017).
The DSM-5-TR recognizes substance-related disorders resulting from the use of 10 separate classes of drugs and four of which Antonio currently uses and are alcohol, cannabis, opioids, and tobacco. (APA 2022) The DSM-5-TR substance use disorder criteria are: 1) Taking the substance in larger amounts than recommended, 2) the inability to cut down or stop using the substance. 3) Spending a great deal of time locating and using the substance. 4) Cravings and urges to use the substance 5) Not managing to do what is expected of you at work, home or school because of substance use 6) the continued use of the substance regardless of the problems caused at work, school, or home 7) Giving up important social, occupational or recreational activities because of the substance use 8) Using the substances repeatedly regardless of the danger 9) Continued use of the substance when there is a physical, psychological problem that could be made worse by the substance 10) Needing more of the substance to gain the desired effect and 11) Developing withdrawal symptoms, which can be relieved by taking more of the substance. The DSM-5-TR groups the 11 criteria into four primary categories: Physical dependance, risky use, social problems, and impaired control. The DSM-5-TR assigns a severity
level for the substance use disorder depending on how many symptoms are present. This severity
is Mild, with two or three symptoms, Moderate, four or five symptoms and Severe, with six or
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