Substance Abuse

After reviewing the case study provided it is very evident that Matt has a substance abuse problem. He is a college student who is struggling to find a sense of belonging. He spends a great deal of time alone worrying about the financial burden he is placing on his family. His mother currently reported concern with Matt's drinking habits, because her husband is a recovering alcoholic. His friends and roommate are suspicious about his use of alcohol and possibly even other substances such as cocaine.

I feel the theoretical perspective that coincides with Matt's substance abuse is the adaptive model. His father is a recovering alcoholic, who most likely drank around his children while they were growing up. Even though Matt was ashamed by his father's behavior when he was drinking, Matt probably saw that his father used alcohol to cope with the stress of every day life. Matt also has to deal with the stress of college and the feeling of not belonging and sees that the other students drink to have a good time and forget about their problems, however; beings he has a predisposition to alcoholism, excessive drinking could get him into trouble. He is adapting to a new environment and is coping by one of the methods he learned growing up.

Matt's substance that he is abusing is alcohol. Alcohol exerts a depressant effect on the CNS, resulting in behavioral and mood changes. Our textbook discusses the four phases that an alcoholic's drinking patterns progress. The first is the prealcoholic phase, the phase in which alcohol is used to relieve the tensions of everyday life. This stage also deals with the child learning drinking habits from a parent. The next phase is the early alcoholic phase; this phase begins with blackouts and amnesia. This is when alcohol is not just used in moderation, but when it is needed by the individual. The 3rd phase is the crucial phase, where the individual has lost control of his drinking habits. These episodes can be noticed by unexplained sickness, loss of consciousness, squalor, and degradation. The last phase is the chronic phase, which is characterized by emotional and physical depletion. Depression and physical symptoms such as tremors and hallucinations are common (Townsend, 412). In low doses of alcohol it can produce a relaxation, loss of inhibitions, lack of concentration, drowsiness, slurred speech, and sleep. Some of the other effects on the body due to chronic alcohol use include peripheral neuropathy, alcoholic myopathy, wernicke's ensephalopathy, korsakoff's psychosis, alcoholic cardiomyopathy, esophagitis, gastritis, pancreatitis, alcoholic hepatitis, cirrhosis of the liver, leukopenia, thrombocytopenia, and even sexual dysfunction. Other negative effects on the individual include aggressive impulses, mood lability, impaired judgment, impaired social functioning, unsteady gain, nystagmus, and flushed face. Withdrawals begin 4-12 hours of cessation or reduction of alcohol use. Symptoms include; coarse tremor of hands, tongue, or eyelids, nausea or vomiting; malaise or weakness; tachycardia; sweating; elevated blood pressure; anxiety, depression, irritability; hallucinations; headache; and insomnia (Townsend, 414).

Matt is in a detoxification center and displays many of the signs and symptoms of alcoholism that I have noted. He denies use of alcohol, however; smells of alcohol, his face is flushed, his speech is slurred, and he has urinated on himself, he has vomited several times, and is verbally abusive to the staff. His roommate when questioned found pieces of a broken mirror and thinks Matt has been using cocaine. Alcohol is a gateway drug which means it often times leads to other drugs such as cocaine, so it is very possible his roommate is right about his inclination. Also alcohol acts as a depressant so the pieces of broken mirror could have been from or been leading to a suicide attempt. When people are drunk they lose the ability to have rational thoughts and sometimes feel that things will not get better and that suicide is the only way out of a bad situation.

Matt the substance abuser is the central figure in the family. It is hard for families to cope with substance abuse and is an issue that can't be overlooked. In this families case I would say the father is the chief enabler. He is obviously trying to overlook that his son has a problem. He states that drinking is a normal part of a young man in college and expects his son to still graduate early. The mother was suspicious of her sons drinking habits and realizes that alcoholism runs in the family and is going to be a struggle for her son. From the sounds of it Matt's parents are going to be his support system and do what is necessary to help there son with his problem.

The nurse plays a very important role in helping Matt to go through detoxification. Treatment for AWS is based