Question by : Alexia entered the inpatient treatment program where you are a chemical dependency counselor. She stated that?
Alexia entered the inpatient treatment program where you are a chemical dependency counselor. She stated that she needs help for drug addiction and possibly alcoholism. She is a 32-year-old, divorced, Caucasian woman, employed as an administrative assistant at a local human services program. She lives with her 11-year-old daughter, Christine, in an apartment located near her job. Although she makes a relatively low salary, Alexia has managed to support herself and her daughter without financial support from Christine’s father. Alexia was married briefly to Christine’s father when she was 20, but left him after he became physically and sexually abusive toward her. He was also an alcoholic. Until recently, she had almost no contact with him for many years. Her widowed mother is a strong support for Alexia and Christine, as are two cousins, Denise and Moira. Alexia reports growing up in a “normal middle class family” and states that her childhood was “good” despite her father’s occasional drinking binges. She is the youngest of five children and the only girl. Alexia reports having little pleasure in life and feeling tired and “dragging” all of the time. She tells you that her difficulty in standing up for herself with her boss at work is a constant stress orShe reports to having tried AA two years ago, but wasn’t able to stay sober for more than six months. She began drinking regularly (several times a week) around the age of 13. She recalls having felt depressed around the same time that she began drinking heavily, although she states she has very few clear memories of that time in her life. Alexia’s drinking became progressively worse over the years, although she did not begin to see it as a problem until after she began using crack cocaine, at around age 28. She reports feeling depressed over much of her adult life; however, her depression got much worse after she began using crack daily. She feels hopeless about her ability to put her life together, and is doubtful that she can achieve sobriety. alexis was recently raped by her drug dealer and his friend, which resulted in a broken jaw and one month’s absence from work. she tell you that she “only got what she deserved” for being in the wrong place with the wrong people at the wrong time. her ex-husband is trying to gain custody of her daughter now that he has been sober for two years. alexis hopes to get sober so she can fight this custody battle, and “be the mother her daughter deserves”.1) i want to know what is actually happening in this client’s life. 2) what must be addressed to improve the situation. 3) how would you asses this client and why. 4)what diagnosis would you give this client and what criteria are you basing this diagnosis on. 5) what treatment options would you recommend for this client and why? 6) what is your working hypothesis about this client’s problems with alcohol and drug issues
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Best answer:

Answer by nickipettis
in no particular order

i suspect she was physically abused in childhood and sexually abused in puberty, 13 and later.
she has worked hard to not remember that.

I have NO idea how she can afford alcohol and drugs and support herself and her daughter on a “relatively low salary.” you should investigate whether she has been prostituting herself for drug money, or paying for her drugs with sex.

Anyone who says “they only got what they deserved” is being emotionally abused, even if there are no other factors. her drug dealer is keeping her dependent not just on drugs, but is lowering her self worth.

She may have started using drugs more seriously at 28?, when her daughter was 7 or 8. this may have triggered memories of her own abuse.

i think the first thing that has to be addressed is that she doesn’t think she CAN get sober.
If she doesn’t think she can get sober, then she certainly can not.

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Question by ॐ Plea for Peace!: why do a lot of schizophrenics like to smoke cigarettes and drink coffee?
i’ve read that something like 90% of schizophrenics smoke cigarettes, and i’ve also heard that a large percentage drink a lot more coffee than those considered normal.

does anyone have any ideas? the smoking i can understand if it’s an obsessive behavior, but i wonder if the nicotine in cigs or the caffeine in coffee has anything to do with it?

Best answer:

Answer by gardensallday
I think I read recently that they have an inability to experience pleasure normally, and cigarettes fill that need. I don’t know about the coffee. I will say that I drink a hell of a lot of coffee & I have bipolar. Oh wait, found this on schizohprenia.com:

Scientists find link for smoking, schizophrenia – Schizophrenia Update, January 2004

A team of Toronto researchers has made a startling discovery about why people with schizophrenia are so much more likely than other people to be smokers.

Medications that block dopamine – commonly used by people with this debilitating condition – make smoking a more rewarding experience, they reported in the journal Molecular Psychiatry.

The findings, which challenge long-held views about the role of dopamine in nicotine addiction, may provide science with clues on how to help schizophrenics and others give up cigarettes and kick other habit-forming drugs.

“It’s a first step in identifying systems in the brain that can mediate vulnerability to addiction,” said lead author Steve Laviolette, who is currently doing post-doctoral research at the University of Pittsburgh.

He admitted, however, that the findings are likely to spark controversy.

“It’s basically overturning 30 years of previous research. So you might come across people who are hostile to – if not shocked by – the results.”

Yavin Shaham, an addiction researcher at the U.S. National Institute on Drug Abuse in Baltimore, Md., agreed that the findings defy some of the dogma around nicotine addiction. But he said the science is sound and the findings will spark debate in the addiction research community.

“I think that it’s very interesting research that points in new directions to understanding nicotine reward,” said Shaham, who was not involved in the research.

“It’s not necessarily the way we thought about it in the past. And it’s certainly relevant for the understanding of why schizophrenics are smoking so much.”

Laviolette wrote the paper with co-author Derek van der Kooy while working on his doctorate in neuropharmacology at the University of Toronto. The pair was trying to identify areas in the brain that are involved in nicotine addiction.

“The schizophrenic angle came up almost accidentally, really,” Laviolette said from Pittsburgh.

The work, done on rats, involved injecting nicotine or a placebo – in this case saline – directly into a portion of the brain known as the ventral tegmental area, or VTA. The VTA is thought to be the pleasure centre of the brain and is known to be involved in nicotine, alcohol and drug addiction.

To the team’s surprise, they discovered the VTA also is involved in aversion. Low doses of nicotine administered to that area of the brain actually induced a negative reaction from the rats. It was only when the dosage crossed a certain threshold that the animals began to perceive it as pleasurable and to seek it out.

“That was surprising, that a single brain area was responsible for both the aversive and the rewarding effects,” Laviolette admitted.

More surprising still was what happened when they gave the rats drugs that blocked the dopamine receptors in the VTA.

For decades, research has shown that dopamine, a neurotransmitter, is responsible for the rewarding effects of nicotine. But researchers could never explain why people with schizophrenia on dopamine-blocking drugs tend to smoke like chimneys.

It didn’t seem to make sense: if dopamine allowed the brain to enjoy smoking and dopamine was blocked, smoking should no longer be a pleasurable experience.

“And what was the surprising thing was the rewarding effects were not blocked at all,” Laviolette said of the rat experiments.

In fact, the contrary was true, he said. Blocking dopamine blocked the adverse effects of nicotine, but ramped up the rewarding sensations induced by the drug. Dramatically.

The findings suggest that schizophrenia medications that block dopamine are fixing one problem but causing another, he said.

“What’s really happening is that you’re blocking dopamine in the schizophrenics, you’re increasing nicotine’s rewarding effects. And that’s why you see 95 per cent of schizophrenics are heavily addicted to nicotine.”

Further, the same effect is probably happening with alcohol and possibly other drugs, Laviolette said.

“It’s a two-edged sword. The drug is removing the psychosis but at the same time making them addicted to these extremely dangerous drugs.”

Not all medications used to treat schizophrenia work by blocking dopamine, however. The newer generation of medications, known as atypical anti-psychotic drugs, work by a different mechanism.

Laviolette said the research suggests that the reactions to a drug induced in the VTA fall on a spectrum from aversion to pleasure. Whether one finds a cigarette satisfying or disgusting may depend on one’s baseline dopamine levels, he said.

and another article with another explanation:
Scientists have found that smoking and schizophrenia are tightly linked, but are not sure why. Could nicotine actually be helping the disorder? If so, then it is a double-edged sword, because smoking is a life-threatening behavior.

Now, new research on the effects of nicotine in people with schizophrenia is beginning to answer these questions and uncover clues that may help to treat this serious disorder.

Schizophrenia is characterized by disordered thinking; hallucinations, such as hearing voices; and delusions, such as paranoid beliefs that people are conspiring against you. Schizophrenia affects about 1 percent of the population and places a substantial burden on those afflicted, their families, and society.

Many people with schizophrenia smoke, and their unique smoking behaviors have led scientists to believe that nicotine, the addicting substance in tobacco, may represent a form of self-medication, normalizing some central nervous system deficits involved in the disorder.

People with schizophrenia smoke up to three times more than the general population and more than most psychiatric populations. Schizophrenia patients who smoke also have higher levels of nicotine in their bodies because they tend to extract more nicotine per cigarette than other smokers.

Nicotine and its brain receptors—proteins on the surface of cells that receive chemical messages—are keys to understanding the links between smoking and schizophrenia. Already, research has revealed that:

Nicotine and its receptors are involved in functions such as cognition or thinking ability, reward, movement, and pain relief.
Schizophrenia patients have fewer and more poorly functioning nicotinic receptors, especially in the hippocampus, cortex, and cells that wrap the thalamus—brain areas involved in several cognitive and sensory deficits of schizophrenia.
Increased nicotine intake—from smoking cigarettes or sometimes from a skin patch, gum, or nasal spray—may temporarily normalize sensory disruptions of schizophrenia. For example, nicotine may improve eye tracking abnormalities, mostly by altering activity in the hippocampus and brain areas involved in eye movement. Nicotine also has been reported to improve the brain’s ability to filter sounds and to respond and adapt to strong sensory inputs.

Cognitive ability in people with schizophrenia may get a boost from nicotine as well, including temporary enhancements in learning, memory, processing speed, and attention. Several studies have examined spatial working memory—the ability to hold information in the brain and recall it when prompted. Spatial working memory is involved in planning, judgment, and attention—tasks that people with schizophrenia find difficult. Schizophrenia patients who smoked or who received nasal spray nicotine temporarily enhanced their spatial working memory, and those who quit had further impairments.

Smoking also may help decrease medication side effects and other symptoms of schizophrenia. According to one study, receiving nicotine through a skin patch reversed the cognitive slowing associated with haloperidol, a common drug for schizophrenia. Nicotine may improve lack of motivation and indifference in this population, as well. However, it remains unclear if nicotine minimizes hallucinations and delusions, and some studies have reported that people with schizophrenia who quit smoking did not experience worsening of their symptoms.

Nicotine may help lessen some symptoms of schizophrenia by increasing deficient levels of the chemical dopamine—which is thought to regulate key emotional responses—in areas of the brain such as the nucleus accumbens and prefrontal cortex. The nucleus accumbens is involved in reward and pleasure, and the prefrontal cortex organizes complex cognitive and social behaviors.

Since evidence shows that nicotine positively affects schizophrenia, scientists are exploring drugs that act like nicotine in the brain but do not have adverse health consequences. Researchers now are working on safer and less toxic drugs that potentially could enhance cognition. These drugs may help treat schizophrenia.

One type of nicotinic receptor, known as the alpha-7 receptor, is proving to be a major target for schizophrenia drug development. These receptors are found in brain regions important for cognition, including the cortex and hippocampus. Already, scientists have completed preliminary tests of drugs for schizophrenic nonsmokers based on a toxin, called anabaseine, found in marine worms and ants. Subjects showed improved sensory processing and cognition, especially attention.

Scientists continue to research the biology and function of different nicotinic receptors. As knowledge advances, so will development of new and safer drugs to help treat s

Answer by nat
they probably lilke the effect the stimulants have on them.

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Question by Sky: Why do some prescription drugs have some really adverse effects on people?
I just came out of kidney surgery yesterday for stones–twice this year alone–and the drugs I’m on have made me really jumpy, nervous, wiped out, and just too energetic for my tastes.

Why am I feeling like this? Is it because I don’t have the same tolerance to meds as some people do, or is it because I lack that “addiction” factor that sometimes pops up with blatant drug abuse?

Thanks.

(Yes, they put a stent in me.)

Best answer:

Answer by rick29148
Nothing is perfect, everything is a compromise. The drug(s) have a side affect, and your doctor has decided that the side affect is not bad enough to have you stop taking it. I has in a truck wreck 5-1/2 years ago, and there were some internal injuries. One of my daily meds is a super niacin pill for spleen damage. If I don’t take it with an asprin at the right time, it will make my skin turn red and try to crawl up my back….not terrible, but not my idea of a good time. Doc says it’s the only med available to keep the spleen producing the white blood cells I need, so, I take the pills. Ask your doc, maybe there is another med you can take that will do the same thing without the side affects… Good Luck.

Answer by Susan Yarrawonga
Prescription drugs are regarded as invasive alien substances by our bodies that reject them and the side effects are basically protests by our bodies.

Unfortunately, we sometimes or even often need prescription medication as it usually works much faster than natural medication which often fails to overcome the relevant medical problem. Natural medication sometimes helps a bit but often not enough so then you have to take prescription medication which is rarely without side effects.

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Question by : How do I tell my parents that I didn’t pass any of my classes this semester?
For reference, I am a junior at a commuter college and decided to take all of my classes online this semester. The lack of structure and freedom was really, REALLY bad for a procrastinator like me, and I wasn’t self-disciplined enough to keep myself on track.
I feel horrible that I’ve let myself and my parents down, but I intend on finishing college and doing infinitely better next semester. How do I tell them all of this in a coherent way?

Best answer:

Answer by Pink
Just tell them

Answer by Bushy Biggons
You accidentally leave this web page open for them to see!
Seriously, that’d work better than anything else… Just make sure your display name is your real name so they don’t go ‘oh that bad kid’, I know my daughter/son would do better *sees results* WTF!!!! :@

That is all.

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