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Diagnostic and Statistical Manual

DSM IV), substance abuse is a maladaptive pattern of alcohol or drug use leading to clinically significant impairment or distress (American Psychiatric Association, 2000). Substance abuse includes taking a psychoactive drug or performance enhancing drug for a non-therapeutically or non-medical effect. From the case study, Ashley is caught up in psychoactive drugs, which bring about subjective changes in consciousness as well as mood; for instance, increased alertness.

Diagnostic and Statistical Manual, a classification of mental disorder have been used to provide systematic description of each disorder in regard to age of onset, probable course, predisposing factors, associated features and differential diagnosis. This criterion has also been used to diagnose substance use disorder categorically acute intoxication, abuse, dependence, withdrawal, delirium among others. It is in this light that I decided to borrow from this criterion to describe Ashley substance abuse problem.

The following elements are crucial in the diagnosis process; I) HISTORY TAKING To begin with, an elaborate history of Ashley condition is important. Obtaining accurate information from victims of substance abuse is often a difficult task because of the stigma associated with it and fears of legal consequences, however using appropriate counseling skills and constant assurance to the client of confidentiality will

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help in obtaining the accurate information on the existence, severity, duration and effects of the substance from Ashley.

Information on the type of drug, amount, mode of administration and purpose for taking the drug will be collected at this stage. Family history on use of any substance will also be assessed to evaluate any recurrent habits in the family line. ii) DIAGNOSIS OF ABUSE AND HARMFUL USE This will be carried out to assess any symptoms of abuse or harmful use of the drug. This diagnosis is particularly evident in people who have begun to experience problems due to drug use as is in the case with Ashley.

In the case, Ashley is experiencing lack of sleep which is a problem due to the diet pill use. This clearly indicates presence of drug abuse and harmful use due to the fact that the drug is not used for any medical prescription, as illustrated from the case study. iii) DRUG DEPENDENCE At this stage Ashley dependence on the diet pill will be assessed. According to DSM-IV-TR criteria for substance dependence, a patient will be diagnosed as dependent on drugs if a maladaptive pattern of substance use leading to clinically significant impairment or distress is manifested.

These maladaptive patterns are manifested by a markedly consistent need for increased amount of the abused substance, dependence on the substance to avoid withdrawal symptoms, unsuccessful efforts to cut down or control substance use, important social occupational or recreational activities are given or reduced because of substance abuse. From the description above Ashley shows signs of dependence on the diet pill. According to the case study Ashley has a markedly increased need for the diet pill, and her effort to stop results in withdrawal symptoms like depression and lack of sleep.

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