As you prepare to interview a client, you become aware of some behaviors that suggest she may be using an illegal substance. There is a strong chemical odor on her breath. You decide that the best strategy is to refer her for a drug test, yet you do not want to rush to judgment because you may be wrong. As a precaution, you decide to call the nurse practitioner who is on duty. You explain the situation and the nurse agrees to come to your office right away. The nurse practitioner examines your client. She quickly determines that the client is experiencing ketoacidosis (key'-to-a'-sid-o'-sis), a symptom of type 1 diabetes mellitus. It is often associated with long-term alcoholism. The disease produces an odor similar to nail polish remover. You are relieved that the client's medical issue was identified and can now be treated. This is a reminder that many clients have a collection of health problems, in addition to their addiction. You think to yourself, "As a case manager, what warning signs must I be aware of when meeting with clients? What procedures must I follow when I suspect use or abuse?"

To prepare for this Assignment, review the media program, Two Clients, and the Learning Resources for this week (See attached). Consider the signs and symptoms of abuse and whether you notice any signs of drug use or abuse in the media scenario.

Write a 2-page paper that includes an explanation of the types of behaviors you observed in the two clients profiled in the media program. Explain your reasoning for any behavior that you observed that could be a sign of drug use. Use the Learning Resources to justify your position. Based on the observations you have made, explain whether you need to refer this client to another professional on the service team and why?

APA and in text citation and all resources cited

References:

National Institute on Drug Abuse. (2012a). NIDA quick screen: Clinician's screening tool for drug use in general medical settings. Retrieved fromhttp://www.drugabuse.gov/nmassist/

NAADAC, The Association for Addiction Professionals. (2011b). NAADAC Code of Ethics Principles. Retrieved from http://www.naadac.org/code-of-ethics

NAADAC, The Association for Addiction Professionals. (2011a). Ethical standards of alcoholism and drug abuse counselors. Alexandria, VA: Author.

Summers, N. (2012). Fundamentals of case management practice: Skills for the human services (4th ed.). Belmont, CA: Brooks/Cole Cengage.

Program Transcript-

Kyra is 24 years old and works as a claims representative at an insurance company. Her job's employee assistance program has referred her to treatment. Last year, she went through a difficult divorce, lost custody of her 3-year-old son, and now feels everyone is
against her.

She has been treated for depression in the past and has seen a psychiatrist who prescribed medication. She did not like how the medications made her feel: She found that they upset her stomach and made her feel dizzy. She stopped taking them but did not inform her doctor. As a result, she had a sudden reaction that required hospitalization. Her biggest complaint is that she is having trouble sleeping. Kyra says that she has "a few" glasses of wine each evening in order to "wind down" and help with her mild insomnia. She also finds it helpful to occasionally take a sleeping pill. She estimates that she takes a sleeping pill "a couple of times" each week.

She also says that she is having some difficulty at work. She feels that her coworkers are treating her differently, and she finds it hard to get through the day. She says she used to enjoy her job and liked talking with people on the phone, but lately she feels "a little irritated" when calls come in.

Timothy is 29 and is a private first class in the Army. He has been referred to the treatment center by his commanding officer.

He recently returned from Afghanistan, where he served in a combat zone for 10 months. His job was to inspect roadways for hidden explosive devices. He says it was "just a job" but acknowledges that it took a toll on his nerves. He says he often feels "jumpy" and sometimes looks for "substances" that will help him calm down.

This had been his second tour of duty overseas. During the first tour, a bomb exploded and injured his ankle. He was treated for the injury, given painkillers, and returned to combat the following year. He says although it was hard, he did stop taking the medication.