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CID460 Health And Social Care

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CID460 Health And Social Care

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Course Code: CID460
University: University Of Sunderland

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Country: United Kingdom

Question: 
1. Critically analyse the reasons why people take drugs.In this essay you will need to explore reasons why people take drugs, examine prevalence rates, and evaluate theories of addiction. You could also include attitudes to drug taking, within different arenas such as public, government and media.
 
2. Critically analyse the relationship between eithera) drugs and crime or b) drugs in prison
 
In either of these questions there should be links made between drugs and crime. The theoretical understanding of these links need to be established and some attempt at establishing how intervention may (or may not) work in this regard.
 
3. Choose a type of drug (legal or illicit) and critically explore and analyse the interventions which may be applied when its usebecomes problematic.
 
For this essay you initially need to explore the meaning of problematic drug use in defining your terms. You also need to examine the associated issues linked to this ‘problematic’ use and how this may impact upon the individual, family, community and/or society. What routes of intervention may be taken and assess the relative effectiveness of this, suggesting alternative interventions 
Answer: 

Illicit drugs are those that are illegal to make, sell as well as to use. Most of the illicit drugs are seen to be highly addictive and they pose serious risks on the physical as well as the mental health of human beings who use them. Researchers have noted that these drugs mainly begin as an experiment or might also begin because of curiosity (Jones et al. 2013). In the other cases, it is seen to mainly begin from the instances of using prescription pain medication that are prescribed for treatment of an illness or for an injury. Over the course of time, it is seen that a user may become hooked on the mental as well as the physical effects of the drug. Often the user is seen to use more of the drugs to get on the desired effects. Without help, such individuals become highly vulnerable to different types of threats such as health issues or safety issues (Bogenschutz et al. 2014). This assignment would be mainly depicting one of the most harmful drug called the heroin and how it affect the life of the user in many ways. It will also show how different interventions need to be taken by the healthcare government so that effective care is provided to help them withdraw themselves from such addiction.
Problem or problematic drug use can be referred as the drug use that might be dependent as well as recreational. It must be remembered that it is not the frequency of the drug use, which is the primary “problem”, but actually the effects that the habit of drying taking might have on the life of the user. The user might experience social, psychological, financial, physical as ell as the legal problems as the result of the effects of the drugs. Addiction is the word that is closely associated with the problematic drug abuse. Addiction can be referred to as the disease that has the capability of affecting the brain as well as the behavior (Bucehl et al. 2017). When an individual becomes addicted to the drugs, the person cannot resist the urge of using them no matter how much harm each of the drugs might cause them. Initially individuals believe that they may chose to take the drug because of the pleasure or the way it makes them feel. The individual may think that he has the entire capability to control the amount as well as the frequency of taking the drugs. However, in course of time, drugs start on altering the control of the brain. The physical challenges are seen to last over a long period. The individual gradually starts to lose the self-control and this in turn lead to damaging behaviors (Carlson et al. 2016).
Heroin can be defined as the opioid drug that is prepared from the substance called morphine. It is also the natural substance that is usually extracted from the seedpod of the various opium poppy plants. These are mainly grown in the regions like that of the southeast as well as the southwest Asia, Mexico as well as Columbia (Johnston et al. 2018). It can be either a white as well as the brown powder or it can also be a black substance which is quite sticky and is called the black tar heroin as well. People are mainly seen to take in the drug either by injecting, sniffing, snorting as well as smoking heroin. Many of the people are seen to form a mixture of heroin with that of crack cocaine and different people mainly call this practice as the process of speedballing.
Huge number of effects may result when persons gets engaged in problematic use of drugs especially of that of heroin. It mainly enters the brain in a rapid manner and thereby binds to opioid receptors on the cells that are located in different regions. These regions are involved in the feelings of the pain as well as pleasure. These regions are also responsible for the controlling of the heart rate as well as sleeping and even breathing. People who use heroin are seen to feel a rush that is actually a surge for the pleasure as well as the euphoria (Roy et al. 2014). There are many other common effects as well that include drying of the mouth as well as warm, flushing of the skin. Moreover, the individuals also feel heavy on their arms and legs. They also suffer from nausea and vomiting.  There is also severe itching that includes clouded mental functioning. They have also stated in many interviews that they feel like going “on the nod” which is actually a back and forth state of being conscious and semiconscious.
Some of the long-term effects of the use of heroin involve insomnia. They face situations with collapsed veins and this occurs for individuals who inject the drug. The people who sniff or snort the drug are mainly seen to have damaged tissues inside their nose. Infection in the heart lining as well as valves are also seen to occur and symptoms of abscesses with swollen tissue filled with pus are also noticed. Effects like constipation as well as stomach cramping also takes place along with liver as well as kidney disorders (Wegmen et al. 2017). Therefore, all these physical disorders give them a very hard time making them live poor quality lives. Many of the researchers are also of the opinion that lung complications including the prevalence of pneumonia in such individuals are noticed by them. The individuals going through the problematic use of heroin are also seen to suffer from mental disorders that include depression as well as anti-social personality disorder. Sexual dysfunction in the men as well as irregular menstrual cycles in the women is seen to be some of the symptoms that affect such individuals.
Different types of potential effects are also seen to accompany such behavior. The heroin is seen to comprise of additives that include sugar, starch as well as powdered milk. This has the ability to clog blood vessels that lead to permanent damages to the lungs, kidney, brain and the liver. Moreover, in many cases, it is seen that sharing drug injection and the equipments and along wise having impaired judgment from drug abuse can in turn result in increasing the risk for the contraction of the infectious disorders (Klimas et al. 2016). This might include HIV as well as hepatitis that have huge impact on the quality of lives of the people. Overdose of heroin has been seen to increase in the recent years where death due to overdose id reported. Overdose of heroin is mainly seen to occur when an individual utilizes enough of the drugs for producing a life threatening situation mainly deaths. It is seen that when people overdose of heroin, , their breathing is seen to stop and this can lead to decrease in the amount of the oxygen which reaches the brain and this is called the hypoxia. This has the capability of short as well as long-term effects along with different effects on the nervous system. This includes coma as well as permanent damage of the brain (Surrat et al. 2017).
The effects of drugs on the society are quite dangerous. Utilization of heroin results in imposing preventable health burden on the healthcare system of the nation. Abusing of the drugs as well as alcohol can come with different types of side effects that require support as well as resources from the healthcare, lost revenue and even damages and healthcare. Researchers have found out rippling effects of heroin utilization that include different types of activities like sexual assaults, prison sentences as well as foster care placements. It is also seen to include child abuse as well as different work-related injuries. Many researchers are of the opinion that more the certain individuals of the society utilize the drugs, the more the society or the nation pay as the whole. It is also true that heroin use by individuals has the capability of monopolizing the healthcare resources as it has been seen that every year the drug abuse costs around millions of euro (Taylor et al. 2016). Healthcare is always found to be responsible for rehabilitation programs as well as services and different mental disorders as well as other types of injuries that relate to drug abuse and even addiction. Researchers are of the opinion that such drug abuse  seem to impose  a demand of tax as well as healthcare resources which could be directed towards different types of other positively beneficial costs and various types of life saving endeavors. Therefore, such cases should be handled with strictness.
It is also seen to disrupt the family units resulting on extensive toll on the families. This can in turn result in different negative impacts on the societies. One family member abusing the drug has the ability to disrupt normal flow of quality life of all the other members as well. It might create strains of the spousal relationship along with driving the partner of the patient into frustration as well as fatigue. This disrupts their effort at the work as well as in parenting and even affects friendships. It also affects the ability of caring for their own selves. When the parents abuse drugs, it results in the children getting inadequate as well as improper care. This results in poorer childhood health (Kolodny et al. 2015). This also results in reduction of academic performance as well as neglected emotional support and more. As the children of such abusers are denied necessities of the parenting like shelter and food, their involvement as well as contribution to societies, participation in community later on is hindered. Emotional burden gets heavier that makes the children to turn to drugs or alcohol as the coping mechanism and this cyclical negative procedure continues.
Heroin abuse also results in occurrence of different types of crimes. Federal prison occupancy is seen to be accounted for by the individuals that include incarcerations related to drug abuse as well as addiction. Individuals commit all crimes like sexual harassment, theft, ragging as well as threatening other individuals of the society, driving and accidents when they come under the influence of the drug (Cicero et al. 2014).  All these cost society its resources, efforts, time as well as safety. The other negative outcome is that it indirectly affects the GDP of the nation as drug abuse of heroin also causes bringing down of the productivity of the work. The individuals who face the problematic drug use often get late, absent or mentally impaired on the job. This often requires other employees for making up for their lack of productivity. It encompasses straining the work capacity of fellow employees that causes triggering of the irritation as well as exhaustion in these employees. This again has ripple effects on the relationship with the partners, friends as well as the families. This in turn affects the ability of functioning optimally for the work.
Psychosocial interventions can be explained as the structured psychological as well as social interventions that are used for addressing of the substance related problems like the problematic use of heroin. Researchers are of the opinion that such therapies can be utilized at different stages of drug treatment for identification of the problem, treating it as well as assisting it with social reintegration. An effective way, which is often used, by counselors or other healthcare professionals, is the motivational interviewing (Hassamal et al. 2017). It a collaborative conversation method that remains mainly aimed at the strengthening of the motivation of the person and committing to changes. It would be used in many different situations where the healthcare professionals help the individuals to take decisions and accordingly help individuals to overcome the disorder (Vasquez et al. 2017). Another therapy is the brief intervention that mainly includes the collaborative conversation style of the motivational interviewing helping to address the problematic or risky drug use but this is delivered in a shorter timeframe ranging from 5 to 30 minutes. This is mainly believed to be based on the 5As which are based on ask, advise, assess, assist and arrange. Professionals including physicians, nurses and other healthcare workers provide such therapies (Blanken et al. 2016).
Cognitive behavioral therapy is one of the best therapies that help clients in building self-confidence as well as address the thoughts that are believed to be at the root of the drug problems. This therapy helps in learning the recognition and handling of the factors that trigger them. Following the diagnosis of the heroin dependence, licensed therapists provide the therapies in the outpatient settings. Such sessions are nowadays also provided in the residential treatment facilities as well as in the prisons. Family therapies are also another effective mode of management interventions of heroin drug abuse and the different problems behaviors that remain associated with it. This therapy is best applicable during the time of adolescence when heroin use might cause various types of problems like psychiatric symptoms, different types of problems at the schools and different high risk sexual behaviors (Cicero et al. 2017).
Contingency management is mainly seen to be referring to the set of interventions that would involve different concrete rewards for the clients who would achieve their target behaviors (Moore et al. 2016). The approach is also based around recognition and controlling of the relationships between the different behaviors and their consequences. Contingency management is helpful in maintaining the abstinence by the reinforcement of and rewarding of the alternative behavior to the drug use. This is mainly done with the aim of making the abstinence a more positive experience. For example, it can be used during heroin drug treatment of the patient who has remained abstinent or for incentivizing the presence of the user at the work in social re-integration programs. Self-help groups are voluntarily not for profit organizations (Kanouse et al. 2015). In this region, people are mainly seen to meet for discussion as well as addressing of the of the shred addiction problems. They also provide support for each other with the senior members of the team mentoring or sponsoring the new ones. Researchers are of the opinion that as the groups are led by former drug users and hence the situations are well understood by them and interventions provided are much helpful. Such groups can work in different places within the community as well as in healthcare settings and in prisons (Chang et al., 2016).
From the entire discussion, it becomes clear that heroin is an illicit drug coming from opium poppy and problematic use of the drug might lead to addiction. It affects the brain rapidly resulting in both short term and long term effects physically affecting the health of the person. Moreover, it also affects the family of the users where spouse separation and emotional turmoil results. Children in the household have poorer health deprived of healthy childhood, education, shelter and food and in turn get involved in negative cyclical sequence and getting involved in drug abuse. Moreover, it also results in increased expenditure of hospital resources which could have been allocated for severe acute of chronic health issues of other citizens, crimes, jail times, murders, accidents, sexual assaults also results them in legal punishments and hence impacts the society. Moreover, it is also seen that communities can also be affected and productivity of the organizations would be also hampered due to absenteeism, late coming, poor quality work and many others. Different types of interventions can be applied which would include Psychosocial interventions, Motivational interviewing, Brief interventions, Self-help groups, Cognitive behavioral therapy (CBT), Family therapy as well as Contingency management. Healthcare professionals have the responsibility of helping such individuals providing them a safe and quality future.
References:
Blanken, M. Hendriks, A. Huijsman, M. van Ree, and Wim van den Brink 2016. “Efficacy of cocaine contingency management in heroin-assisted treatment: Results of a randomized controlled trial.” Drug and alcohol dependence 164: 55-63.
Bogenschutz, P., Dennis M. Raul N., Harold I. Perl, Alyssa A. Forcehimes, Cameron C, Robert Lindblad 2014 “Brief intervention for patients with problematic drug use presenting in emergency departments: a randomized clinical trial.” JAMA internal medicine 174, no. 11: 1736-1745.
Büchel, C., Peters, J., Banaschewski, T., Bokde, A. L., Bromberg, U., Conrod, P. J., … and Heinz, A. 201). Blunted ventral striatal responses to anticipated rewards foreshadow problematic drug use in novelty-seeking adolescents. Nature communications, 8, 14140.
Carlson, G., Ramzi W. Nahhas, Silvia S, and Raminta 2016. “Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history study.” Drug and alcohol dependence 160  127-134.
Chang, Y, and Peggy C 2016. “Opioid misuse/abuse and quality persistent pain management in older adults.” Journal of gerontological nursing 42, no. 12 : 21-30.
Cicero, J., Matthew S. Ellis, L. Surratt, and Steven P. Kurtz 2014. “The changing face of heroin use in the United States: a retrospective analysis of the past 50 years.” JAMA psychiatry 71, no. 7: 821-826.
Cicero, J., Matthew S., and Zachary A. 2017. “Increased use of heroin as an initiating opioid of abuse.” Addictive behaviors 74 63-66.
Johnston, D., Richard A. Miech, Patrick M. O’Malley, Jerald G. Bachman, John E. Schulenberg, and Megan E. Patrick 2018.. “Monitoring the Future national survey results on drug use, 1975-2017: Overview, key findings on adolescent drug use.”
Jones, M., Joseph Logan, R. Matthew and Michele K.. “Vital signs: demographic and substance use trends among heroin users—United States, 2002–2013.” 2016: MMWR. Morbidity and mortality weekly report 64, no. 26 719.
Kanouse, B., and Peggy C 2015. “The epidemic of prescription opioid abuse, the subsequent rising prevalence of heroin use, and the federal response.” Journal of pain & palliative care pharmacotherapy 29, no. 2: 102-114.
Klimas, J, Evan W, Paul N, Huiru D, Michael J Milloy, Thomas K, and Kanna H 2016:. “The impact of enrolment in methadone maintenance therapy on initiation of heavy drinking among people who use heroin.” European addiction research 22, no. 4 210-214.
Kolodny, T. Courtwright, S. Hwang, Peter Kreiner, L. Eadie, Thomas W. Clark, and G. Caleb Alexander 2015. “The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction.” Annual review of public health 36: 559-574.
McIntosh, James. Beating the dragon: The recovery from dependent drug use. Routledge, 2014.
Moore, Brent A., David A., Christopher J., Frank D. Buono, Declan T. Barry, Lynn E., Patrick G. O’Connor, and Richard S. 2016. “Cognitive behavioral therapy improves treatment outcomes for prescription opioid users in primary care buprenorphine treatment.” Journal of substance abuse treatment 71 (2016): 54-57.
Roy-Byrne, P., Bumgardner, K., Krupski, A., Dunn, C., Ries, R., Donovan, D., West, I.I., Maynard, C., Atkins, D.C., Graves, M.C. and Joesch, J.M., 2014. Brief intervention for problem drug use in safety-net primary care settings: a randomized clinical trial. Jama, 312(5), pp.492-501.
Surratt, L., Steven P. Mance B, Maria A. Levi-Minzi, E. Pagano, and Theodore J. 2017. “Heroin use onset among nonmedical prescription opioid users in the club scene.” Drug and alcohol dependence179: 131-138.
TaylorSt, Julian B, and Tammy A 201). “Prohibition, privilege and the drug apartheid: The failure of drug policy reform to address the underlying fallacies of drug prohibition.” Criminology & Criminal Justice 16, no. 4: 452-469.
Vázquez, H., Alberto Forte, Sebastián C, Leonardo T, and Ross J. Baldessarini 2017. “Treatment implications for bipolar disorder co-occurring with anxiety syndromes and substance abuse.” The Treatment of Bipolar Disorder: Integrative Clinical Strategies and Future Directions 
Wegman, P., Frederick L, Sangeeth K, Vanesa R, Sutayut O, David W, David P. Wilson, and Adeeba K 2017. “Relapse to opioid use in opioid-dependent individuals released from compulsory drug detention centres compared with those from voluntary methadone treatment centres in Malaysia: a two-arm, prospective observational study.” The Lancet Global Health 5, no. 2: e198-e207.

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